Comparison of clinical outcomes between patellar resurfacing and nonresurfacing in total knee arthroplasty: retrospective study of 130 cases

OBJECTIVE

To compare clinical outcomes between patellar resurfacing and nonresurfacing in total knee arthroplasty (TKA).

METHODS

Data from osteoarthritis patients who underwent TKA and were followed up for ≥ 9 years were analysed retrospectively. Patients were divided into two groups: patellar nonresurfacing group and patellar resurfacing group. In the nonresurfacing group, the partial lateral facet of the patella was removed, the patella was reshaped to match the trochlea of the femoral prosthesis and circumpatellar denervation was performed. In the resurfacing group, the patella was resurfaced with a cemented component. Clinical outcomes included incidence of anterior knee pain, Knee Society Score, patient satisfaction, revision rate and radiographic findings.

RESULTS

Of the 130 patients included, 71 were assigned to the nonresurfacing group and 59 to the resurfacing group. No significant between-group differences were observed for any clinical outcomes measured. The incidence of anterior knee pain was 14.1% (nonresurfacing group) and 5.1% (resurfacing group). The revision rate was 9.89% (nonresurfacing group) and 3.4% (resurfacing group).

CONCLUSION

Clinical outcomes for patellar nonresurfacing, including patelloplasty and circumpatellar denervation, are similar to those for patellar resurfacing, in TKA.

Emmprin and KSHV: new partners in viral cancer pathogenesis

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Emmprin regulates pathogenic elements relevant to virus-associated cancer, including drug resistance and cell migration.

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Kaposi's sarcoma-associated herpesvirus (KSHV) regulates emmprin expression and downstream function.

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Targeting emmprin or its interacting proteins at the cell surface suppresses KSHV-induced pathogenesis in vitro.

Emmprin (CD147; basigin) is a multifunctional glycoprotein expressed at higher levels by cancer cells and stromal cells in the tumor microenvironment. Through direct effects within tumor cells and promotion of tumor–stroma interactions, emmprin participates in induction of tumor cell invasiveness, angiogenesis, metastasis and chemoresistance. Although its contribution to cancer progression has been widely studied, the role of emmprin in viral oncogenesis still remains largely unclear, and only a small body of available literature implicates emmprin-associated mechanisms in viral pathogenesis and tumorigenesis. We summarize these data in this review, focusing on the role of emmprin in pathogenesis associated with the Kaposi sarcoma-associated herpesvirus (KSHV), a common etiology for cancers arising in the setting of immune suppression. We also discuss future directions for mechanistic studies exploring roles for emmprin in viral cancer pathogenesis.

Inbreeding and genetic diversity in three imported Swine breeds in china using pedigree data

The accumulation of inbreeding and the loss of genetic diversity is a potential problem in the modern swine breeds in China. Therefore, the purpose of this study was to analyze the pedigrees of Chinese Duroc (CD), Landrace (CL) and Yorkshire (CY) swine to estimate the past and current rates of inbreeding, and to identify the main causes of genetic diversity loss. Pedigree files from CD, CL and CY containing, 4529, 16,776 and 22,600 records, respectively, were analyzed. Pedigree completeness indexes of the three breeds, accounting for one generation back, were 83.72, 93.93 and 93.59%, respectively. The estimated average annual inbreeding rates for CD, CL and CY in recent three years were 0.21, 0.19 and 0.13%, respectively. The estimated average percentage of genetic diversity loss within each breed in recent three years was about 8.92, 2.19, and 3.36%, respectively. The average relative proportion of genetic diversity loss due to unequal contributions of founders in CD, CL and CY was 69.09, 57.95 and 60.57%, and due to random genetic drift was 30.91, 42.05 and 39.43%, respectively. The estimated current effective population size for CD, CL and CY was 76, 117 and 202, respectively. Therefore, CD has been found to have lost considerable genetic diversity, demanding priority for optimizing the selection and mating to control future coancestry and inbreeding. Unequal contribution of founders was a major cause of genetic diversity loss in Chinese swine breeds and random genetic drift also showed substantial impact on the loss of diversity.

OLA1 protects cells in heat shock by stabilizing HSP70

The heat-shock response is an evolutionarily conserved cellular defense mechanism against environmental stresses, characterized by the rapid synthesis of heat-shock proteins (HSPs). HSP70, a highly inducible molecular chaperone, assists in refolding or clearance of damaged proteins, thereby having a central role in maintaining intracellular homeostasis and thermotolerance. To date, induction of HSP70 expression has been described extensively at the transcriptional level. However, post-translational regulation of HSP70, such as protein stability, is only partially understood. In this study, we investigated the role of OLA1 (Obg-like ATPase 1), a previously uncharacterized cytosolic ATPase, in regulating the turnover of HSP70. Downregulation of OLA1 in mammalian cells by either RNAi or targeted gene disruption results in reduced steady-state levels of HSP70, impaired HSP70 induction by heat, and functionally, increased cellular sensitivity to heat shock. Conversely, overexpression of OLA1 correlates with elevated HSP70 protein levels and improved thermal resistance. Protein–protein interaction assays demonstrated that binding of OLA1 to the HSP70 carboxyl terminus variable domain hinders the recruitment of CHIP (C-terminus of Hsp70-binding protein), an E3 ubiquitin ligase for HSP70, and thus prevents HSP70 from the CHIP-mediated ubiquitination. These findings suggest a novel molecular mechanism by which OLA1 stabilizes HSP70, leading to upregulation of HSP70 as well as increased survival during heat shock.

Transcriptional activity of an ovarian-specific promoter from rat in dairy goat granulosa cells

Ovarian-specific promoter 1 (OSP-1) is a retrovirus-like element isolated from the complementary DNA library of rat that has been thought to be specifically expressed in ovary. To exploit this promoter in dairy goat ovary granulosa cells (GCs), OSP-1 from rat was used to construct the reporter vector pOSP-1-EGFP, in which egfp coding for enhanced green fluorescent protein (EGFP) was used as a reporter to examine the activity of OSP-1 in GCs. EGFP was successfully expressed in dairy goat GCs transfected with pOSP-1-EGFP. Reverse transcriptase-polymerase chain reaction analysis confirmed the tissue-specific transcription of EGFP messenger RNA in dairy goat GCs transfected with pOSP-1-EGFP. We concluded that OSP-1 promoter from rat can specifically drive foreign gene expression in dairy goat GCs. Thus, we obtained a tissue-specific regulation element and provided a potential tool for the research of regulation and development of the ovary in dairy goats.

Construction of Foot-and-mouth disease virus 2A-based bicistronic expression vector and coexpression of two genes in goat mammary epithelial cells

Using animal mammary glands as bioreactors for producing commercially important proteins is a cutting-edge direction in the field of biotechnology development and application. Dairy goats are an important dairy livestock, with roughage-resistance, fast propagation, long lactation periods and high milk production per bodyweight; these characteristics make dairy goats ideal for use as mammary gland bioreactors. Foot-and-mouth disease virus 2A (FMDV 2A) is an efficient viral cleavage element that mediates proteolytic cleavage independent of the presence of other FMDV sequences. It is often incorporated into recombinant vectors to generate cleavage in the presence of heterologous sequences. To achieve specific co-expression of two heterologous genes in goat mammary gland epithelial (GMGE) cells, a mammary gland-specific bicistronic expression vector, pFIEβ, containing the β-casein 5′ flanking sequence and FMDV 2A, was successfully constructed and the specific expression of human interleukin 2 (hIL-2) and enhanced green fluorescent protein (EGFP) was conducted in primary GMGE cells. Another bicistronic expression vector, pFIEC, driven by the cytomegalovirus promoter, was constructed as a positive control. In cells transfected with pFIEβ and pFIEC, RT-PCR verified the existence of recombinant fusion mRNA of hIL-2 upstream of EGFP within the FMDV 2A cassette fragment and western blot analysis showed the existence of the fusion between hIL-2 and EGFP. It is concluded that FMDV 2A generated specific co-expression of multiple genes for the first time in primary GMGE cells driven by the β-casein promoter.

45 EFFECT OF DEACETYLASE INHIBITOR VALPROIC ACID ON BOVINE CULTURED SOMATIC CELLS

Normal development depends on a precise sequence of changes in the configuration of chromatin. Epigenetic modifications, such as histone acetylation and methylation and DNA methylation, control the precise tissue-specific gene expressions. Valproic acid (VPA) is an aliphatic acid compound and a deacetylase inhibitor that influences cellular proliferation, differentiation, apoptosis, and migration. Several studies have shown that treatment of fused, cloned embryos with VPA improved embryo development. However, whether the treatment of donor cells with VPA affected cloned embryo development was not clear. In the present study, bovine fibroblast cells were treated with VPA at 0, 0.25, 0.5, 1.0, 2.0, and 4.0 mM concentrations for 24 and 48 h, respectively. The cell growth, cell cycle, diploid composition, and histone modifications were examined. The results showed that (1) when the cells were treated with VPA at and over 2.0 mM concentrations for 24 or 48 h, cell growth was significantly inhibited; (2) VPA treatment resulted in a decrease in cell diploid composition; (3) VPA induced the arrestment of cells at the G0/G1 stages; (4) VPA treatment increased early cell apoptosis; (5) VPA at a 4.0 mM concentration and treatment of cells for 24 h improved H3K9 acetylation; however, treatment of cells with VPA decreased H3K9 methylation in all experimental groups; and (6) when the cells treated with VPA at 0, 0.25, 0.5, 1.0, and 2.0 mM concentrations for 24 h were used as donor cells for NT, the cleavage rates were 83.2, 80.0, 82.1, 80.5, and 65.5%, respectively, and the percentages of blastocyst development were 30.5, 29.6, 29.2, 25.0, and 15.5%, respectively. When the cells were treated with VPA at 4.0 mM concentration, the cleavage (65.5%, 76/116) and blastocyst development (15.5%, 18/116) significantly decreased as compared with the control [83.2% (158/190) and 30.5% (58/190), respectively]. The cell numbers of the blastocysts derived from VPA treatment at 0, 0.25, 0.5, 1.0, and 2.0 mM concentrations were 89.6, 88.6, 87.6, 75.0, and 71.3, respectively, which decreased with the increase in VPA concentration. In conclusion, VPA affected cell growth and histone modifications in a concentration-dependent manner. The VPA-treated cells did not improve the cloned embryo development and even decreased blastocyst when VPA was at a high concentration. This work was supported by the National Basic Research Program of China (no. 2012CB22306).

Abstract P6-11-11: Multistage Delivery of Paclitaxel: Increased Drug Stability and Sustained Release Results in Enhanced Efficacy in Breast Cancer

Background: A significant challenge for effectively treating cancer is overcoming biological barriers that reduce circulation times and increase degradation of possible treatments. We established an innovative approach to address this issue by embedding drug-containing nanoparticles within the pores of a larger mesoporous silicon particle (MSP) in order to optimize site-specific localization and release of therapeutic agents. The objective is to develop a nanotherapeutic-based multistage platform for breast cancer treatment, wherein paclitaxel, a mitotic inhibitor used in the treatment of breast tumors, will be loaded into polymeric micelles, which in turn will be loaded within MSPs. We hypothesize that this nested incorporation of drugs within MSPs, combined with enhanced tumor transport, will result in a more pronounced and sustained antitumor effect.

Materials and Methods: Micelles were assembled from amphiphilic block copolymers consisting of poly(ethylene glycol)-poly(∈-caprolactone) (PEG-PCL, MW = 5k-5k). Nanoparticle size, zeta potential, and morphology was determined, and PTX loading and release kinetics from micelles analyzed. Drug-containing micelles were incorporated into MSPs by a previously established dry-loading method, wherein nanoparticles were incorporated into pores via capillary action. Loading of fluorescent micelles was used to verify loading within MSPs via fluorescence microscopy and flow cytometry analysis. Sulforhodamine B assays were used to evaluate the in vitro antitumor efficacy of the platform in MCF-7 and MDA-MB-468 breast cancer cells. In vivo efficacy was evaluated in MDA-MB-468 breast tumors in female nu/nu mice.

Results: Resulting micelles had an average size of 20 nm, as confirmed through TEM, with paclitaxel loaded into micelles very effectively. Release kinetics showed that 50% of the drug was released within 4 hours and 80% released within 24 hours. Loading of micelles into MSPs depended largely on electrostatic interactions, with micelles loading better within pores of MSPs displaying increased positive charge. Micelle loading into MSPs was successful as demonstrated by flow cytometry, and release was significantly retarded (< 30% of drug released over 4 d). Incubation of micelle-containing MSPs with breast cancer cells in vitro showed that MSPs could be internalized by cells, after which a sustained and delayed release of the payload was observed in cells. Breast tumors treated with MSPs demonstrated sustained tumor suppression (169 mm3 compared to initial starting volume of 200 mm3) at day 35 following a single injection. It is important to note that sustained tumor efficacy was achieved with nanoparticle and free drug formulations, however, with the caveat of repeated administrations.

Discussion: A novel multistage approach to chemotherapy effectively allows a secondary payload to be loaded and preserved within the MSPs until reaching the tumor site. This prevents premature release of the drug and allows for a sustained release which may potentially result in fewer patient side effects. Future studies will involve loading of multiple nanoparticle types into MSPs and addition of targeting and diagnostic components.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-11-11.

Polymorphism identification in the goat <i>THRSP</i> gene and association analysis with growth traits

Abstract. cIn this study, we reported the analysis of THRSP gene polymorphisms in 610 goats of three breeds: Xinong Saanen (SN), Guanzhong (GZ) and Boer (BG). We identified new allelic variant: P2-G39294A (GenBank acc. no. JN618075) in the three goat breeds. At P2 locus, GG, GA and AA genotypes were found in the three goat breeds. The frequencies of G allele were 0.54–0.55 and frequencies of A allele were 0.46–0.45, and the PIC was 0.37. The SNP locus was in Hardy-Weinberg disequilibrium in Boer goat breed (P<0.05). Association of polymorphisms with growth traits was done at P2 locus in Boer goat breed. The result showed that AA genotype had remarkable growth traits at P2 locus (P<0.05). Therefore, these results suggest that THRSP gene is a strong candidate gene that affects growth traits in goat.

Randomized Prospective Study of Olecranon Fracture Fixation: Cable Pin System versus Tension Band Wiring

OBJECTIVE: This prospective, randomized study compared the effectiveness of the cable pin system (CPS) versus tension band wiring (TBW) for olecranon fracture fixation. METHODS: Patients with acute transverse or slight oblique olecranon fractures were randomly divided into two groups: one fixed by CPS and the other by TBW. Clinical outcome data were collected and analysed following a mean duration of 21 months. RESULTS: The mean ± SD fracture healing time was significantly shorter in the CPS group ( n = 30; 9.73 ± 2.02 weeks) compared with the TBW group ( n = 32; 11.13 ± 2.21 weeks). One patient in the CPS group and seven patients in the TBW group experienced postoperative complications; this difference was statistically significant. The mean ± SD Mayo Elbow Performance Score in the CPS group was significantly higher (88.67 ± 6.42) than that in the TBW group (80.78 ± 11.99). Logistic regression analysis showed an association between fixation method and fracture healing time, complications and elbow function. CONCLUSIONS: Internal fixation by CPS is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW.

Prevalence and risk factors of diabetic retinopathy in Chongqing pre-diabetes patients

PURPOSE

To investigate the prevalence of diabetic retinopathy (DR) and relative risk factors among Chongqing pre-diabetes patients.

METHODS

A total of 750 participants were recruited in this cross-sectional study. All participants underwent a complete physical examination and an oral glucose-tolerance test. In all, 110 of the 125 newly diagnosed pre-diabetics and their healthy spouses as controls were examined with fluorescence fundus angiographies, and their blood with biochemical analyses. All the pre-diabetics with DR (23 subjects), 23 normal controls and 23 pre-diabetics without DR were compared for serum concentrations of regulated upon activation, normal T-expressed and secreted (RANTES). Student's t-test was used to compare continuous variables, and χ (2) test and analysis of variance to compare proportions among groups. Multiple logistic regression models were used to determine the risk factors for DR in pre-diabetics.

RESULTS

In all, 20.91% of the 110 pre-diabetics showed mild non-proliferative DR (NPDR). There was a statistically significant difference in serum concentrations of RANTES between pre-diabetics with and without DR (P<0.01), and also between pre-diabetics with DR and normal controls (P<0.01). However, age, body mass index, waist-hip ratio, triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein-C, low-density lipoprotein-C, blood urea nitrogen, blood creatinine, and urine albumin excretion rate seemed to have no reliable relationship with DR in pre-diabetics (P>0.05).

CONCLUSION

The prevalence of DR in Chongqing pre-diabetes patients in the study was about 20.91% and only mild NPDR was found. It seems that RANTES is one possible risk factor associated with DR in pre-diabetics, not age, TG and TC, and others.

Plasma pharmacokinetics and oral bioavailability of the 3,4,5,6-tetrahydrouridine (THU) prodrug, triacetyl-THU (taTHU), in mice

PURPOSE

Cytidine drugs, such as gemcitabine, undergo rapid catabolism and inactivation by cytidine deaminase (CD). 3,4,5,6-tetrahydrouridine (THU), a potent CD inhibitor, has been applied preclinically and clinically as a modulator of cytidine analogue metabolism. However, THU is only 20% orally bioavailable, which limits its preclinical evaluation and clinical use. Therefore, we characterized THU pharmacokinetics after the administration to mice of the more lipophilic pro-drug triacetyl-THU (taTHU).

METHODS

Mice were dosed with 150 mg/kg taTHU i.v. or p.o. Plasma and urine THU concentrations were quantitated with a validated LC-MS/MS assay. Plasma and urine pharmacokinetic parameters were calculated non-compartmentally and compartmentally.

RESULTS

taTHU did not inhibit CD. THU, after 150 mg/kg taTHU i.v., had a 235-min terminal half-life and produced plasma THU concentrations >1 μg/mL, the concentration shown to inhibit CD, for 10 h. Renal excretion accounted for 40-55% of the i.v. taTHU dose, 6-12% of the p.o. taTHU dose. A two-compartment model of taTHU generating THU fitted the i.v. taTHU data best. taTHU, at 150 mg/kg p.o., produced a concentration versus time profile with a plateau of approximately 10 μg/mL from 0.5-2 h, followed by a decline with a 122-min half-life. Approximately 68% of i.v. taTHU is converted to THU. Approximately 30% of p.o. taTHU reaches the systemic circulation as THU.

CONCLUSIONS

The availability of THU after p.o. taTHU is 30%, when compared to the 20% achieved with p.o. THU. These data will support the clinical studies of taTHU.

Completeness of low anterior resection pathology report: a hospital-based audit with recommendations on improving reporting

AIMS

To audit the information content of the pathology report on Low Anterior Resection (LAR) specimens and to provide recommendations in order to improve the existing standard of reporting.

MATERIALS AND METHODS

All the reports of LAR specimens during 2004 - 2005 were collected from the Hospital Information System (HIS). Individual items of information were compared with the minimum data sets provided by the Royal College of Pathologists (RCP).

RESULTS

Fifty-nine reports were audited. Nineteen percent of the reports were classified as satisfactory. Although many items were well reported, only 30.5% (18/59) of the reports contained a statement on the completeness of excision at the circumferential resected margin and only 25.4% of all reports mentioned the relation of tumors to the peritoneal reflection.

CONCLUSION

The information content of the reports on colorectal cancer resection specimens is inadequate. The use of the standard proforma (template) for reporting rectal cancer is therefore recommended, along with improved education, review of laboratory practices in the light of current knowledge, and further motivation of pathologists through their involvement in multidisciplinary cancer management.

Viral and Mycoplasma pneumoniae community-acquired pneumonia and novel clinical outcome evaluation in ambulatory adult patients in China

Few studies have addressed the etiology and clinical outcomes of community-acquired pneumonia (CAP) treated in an ambulatory setting. We investigated the etiology by the culture of Mycoplasma pneumoniae, urine antigen testing of Streptococcus pneumoniae and Legionella pneumoniae, and DNA or RNA determination of eight kinds of respiratory virus DNA or RNA. An etiological diagnosis was made in 51.8% of 197 patients. The most common pathogens were M. pneumoniae (29.4%) followed by influenza virus A, parainfluenza virus, adenovirus, human metapneumovirus (9.6%), and S. pneumoniae (4.1%). Patients with mycoplasma infections were younger, less likely to have comorbidities, and less likely to have adequate sputum for gram stain and culture. Patients with viral infections were older and more likely to have poorly defined nodules on chest X-ray (CXR) or computed tomography (CT) scan. Among patients infected with M. pneumoniae, those with quinolones as initial prescriptions had shorter duration of fever after the initiation of antibiotics than patients with β-lactams, macrolides, or β-lactams + macrolides (p < 0.05). This study suggests that M. pneumoniae and respiratory viruses were the most frequent pathogens found in ambulatory adult CAP patients and quinolones were better than β-lactams, macrolides, or β-lactams + macrolides in the resolution of fever of M. pneumoniae pneumonia.