1
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Schmied C, Nelson MS, Avilov S, Bakker GJ, Bertocchi C, Bischof J, Boehm U, Brocher J, Carvalho MT, Chiritescu C, Christopher J, Cimini BA, Conde-Sousa E, Ebner M, Ecker R, Eliceiri K, Fernandez-Rodriguez J, Gaudreault N, Gelman L, Grunwald D, Gu T, Halidi N, Hammer M, Hartley M, Held M, Jug F, Kapoor V, Koksoy AA, Lacoste J, Le Dévédec S, Le Guyader S, Liu P, Martins GG, Mathur A, Miura K, Montero Llopis P, Nitschke R, North A, Parslow AC, Payne-Dwyer A, Plantard L, Ali R, Schroth-Diez B, Schütz L, Scott RT, Seitz A, Selchow O, Sharma VP, Spitaler M, Srinivasan S, Strambio-De-Castillia C, Taatjes D, Tischer C, Jambor HK. Community-developed checklists for publishing images and image analyses. Nat Methods 2024; 21:170-181. [PMID: 37710020 PMCID: PMC10922596 DOI: 10.1038/s41592-023-01987-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/26/2023] [Indexed: 09/16/2023]
Abstract
Images document scientific discoveries and are prevalent in modern biomedical research. Microscopy imaging in particular is currently undergoing rapid technological advancements. However, for scientists wishing to publish obtained images and image-analysis results, there are currently no unified guidelines for best practices. Consequently, microscopy images and image data in publications may be unclear or difficult to interpret. Here, we present community-developed checklists for preparing light microscopy images and describing image analyses for publications. These checklists offer authors, readers and publishers key recommendations for image formatting and annotation, color selection, data availability and reporting image-analysis workflows. The goal of our guidelines is to increase the clarity and reproducibility of image figures and thereby to heighten the quality and explanatory power of microscopy data.
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Affiliation(s)
- Christopher Schmied
- Fondazione Human Technopole, Milano, Italy.
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Berlin, Germany.
| | - Michael S Nelson
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Sergiy Avilov
- Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany
| | - Gert-Jan Bakker
- Medical BioSciences Department, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Cristina Bertocchi
- Laboratory for Molecular Mechanics of Cell Adhesions, Pontificia Universidad Católica de Chile Santiago, Santiago de Chile, Chile
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | | | | | - Jan Brocher
- Scientific Image Processing and Analysis, BioVoxxel, Ludwigshafen, Germany
| | - Mariana T Carvalho
- Nanophotonics and BioImaging Facility at INL, International Iberian Nanotechnology Laboratory, Braga, Portugal
| | | | - Jana Christopher
- Biochemistry Center Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Beth A Cimini
- Imaging Platform, Broad Institute, Cambridge, MA, USA
| | - Eduardo Conde-Sousa
- i3S, Instituto de Investigação e Inovação Em Saúde and INEB, Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Michael Ebner
- Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Berlin, Germany
| | - Rupert Ecker
- Translational Research Institute, Queensland University of Technology, Woolloongabba, Queensland, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- TissueGnostics GmbH, Vienna, Austria
| | - Kevin Eliceiri
- Department of Medical Physics and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Julia Fernandez-Rodriguez
- Centre for Cellular Imaging Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Laurent Gelman
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - David Grunwald
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Nadia Halidi
- Advanced Light Microscopy Unit, Centre for Genomic Regulation, Barcelona, Spain
| | - Mathias Hammer
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Matthew Hartley
- European Molecular Biology Laboratory (EMBL), European Bioinformatics Institute, Hinxton, UK
| | - Marie Held
- Centre for Cell Imaging, the University of Liverpool, Liverpool, UK
| | | | - Varun Kapoor
- Department of AI Research, Kapoor Labs, Paris, France
| | | | | | - Sylvia Le Dévédec
- Division of Drug Discovery and Safety, Cell Observatory, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | | | - Penghuan Liu
- Key Laboratory for Modern Measurement Technology and Instruments of Zhejiang Province, College of Optical and Electronic Technology, China Jiliang University, Hangzhou, China
| | - Gabriel G Martins
- Advanced Imaging Facility, Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | | | - Kota Miura
- Bioimage Analysis and Research, Heidelberg, Germany
| | | | - Roland Nitschke
- Life Imaging Center, Signalling Research Centres CIBSS and BIOSS, University of Freiburg, Freiburg, Germany
| | - Alison North
- Bio-Imaging Resource Center, the Rockefeller University, New York, NY, USA
| | - Adam C Parslow
- Baker Institute Microscopy Platform, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Alex Payne-Dwyer
- School of Physics, Engineering and Technology, University of York, Heslington, UK
| | - Laure Plantard
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Rizwan Ali
- King Abdullah International Medical Research Center (KAIMRC), Medical Research Core Facility and Platforms (MRCFP), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Britta Schroth-Diez
- Light Microscopy Facility, Max Planck Institute of Molecular Cell Biology and Genetics Dresden, Dresden, Germany
| | | | - Ryan T Scott
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA
| | - Arne Seitz
- BioImaging and Optics Platform, Faculty of Life Sciences (SV), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Olaf Selchow
- Microscopy and BioImaging Consulting, Image Processing and Large Data Handling, Gera, Germany
| | - Ved P Sharma
- Bio-Imaging Resource Center, the Rockefeller University, New York, NY, USA
| | | | - Sathya Srinivasan
- Imaging and Morphology Support Core, Oregon National Primate Research Center, OHSU West Campus, Beaverton, OR, USA
| | | | - Douglas Taatjes
- Department of Pathology and Laboratory Medicine, Microscopy Imaging Center, Center for Biomedical Shared Resources, University of Vermont, Burlington, VT, USA
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Li K, Desai R, Scott RT, Steele JR, Machado M, Demharter S, Hoarfrost A, Braun JL, Fajardo VA, Sanders LM, Costes SV. Explainable machine learning identifies multi-omics signatures of muscle response to spaceflight in mice. NPJ Microgravity 2023; 9:90. [PMID: 38092777 PMCID: PMC10719374 DOI: 10.1038/s41526-023-00337-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
The adverse effects of microgravity exposure on mammalian physiology during spaceflight necessitate a deep understanding of the underlying mechanisms to develop effective countermeasures. One such concern is muscle atrophy, which is partly attributed to the dysregulation of calcium levels due to abnormalities in SERCA pump functioning. To identify potential biomarkers for this condition, multi-omics data and physiological data available on the NASA Open Science Data Repository (osdr.nasa.gov) were used, and machine learning methods were employed. Specifically, we used multi-omics (transcriptomic, proteomic, and DNA methylation) data and calcium reuptake data collected from C57BL/6 J mouse soleus and tibialis anterior tissues during several 30+ day-long missions on the international space station. The QLattice symbolic regression algorithm was introduced to generate highly explainable models that predict either experimental conditions or calcium reuptake levels based on multi-omics features. The list of candidate models established by QLattice was used to identify key features contributing to the predictive capability of these models, with Acyp1 and Rps7 proteins found to be the most predictive biomarkers related to the resilience of the tibialis anterior muscle in space. These findings could serve as targets for future interventions aiming to reduce the extent of muscle atrophy during space travel.
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Affiliation(s)
- Kevin Li
- KBR, Moffett Field, CA, USA
- NASA Space Life Sciences Training Program, Moffett Field, CA, USA
| | - Riya Desai
- College of Letters and Science, University of California at Davis, Davis, CA, USA
| | - Ryan T Scott
- KBR, Moffett Field, CA, USA
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA
| | - Joel Ricky Steele
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA
- Monash Proteomics and Metabolomics Platform, Monash Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
- Blue Marble Space, Seattle, WA, USA
| | | | | | | | - Jessica L Braun
- Department of Kinesiology, Centre for Bone and Muscle Health, Brock University, St. Catharines, Canada
| | - Val A Fajardo
- Department of Kinesiology, Centre for Bone and Muscle Health, Brock University, St. Catharines, Canada
| | - Lauren M Sanders
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA.
- Blue Marble Space, Seattle, WA, USA.
| | - Sylvain V Costes
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA.
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Tierney BT, Kim J, Overbey EG, Ryon KA, Foox J, Sierra M, Bhattacharya C, Damle N, Najjar D, Park J, Garcia Medina S, Houerbi N, Meydan C, Wain Hershberg J, Qiu J, Kleinman A, Al Ghalith G, MacKay M, Afshin EE, Dhir R, Borg J, Gatt C, Brereton N, Readhead B, Beyaz S, Venkateswaran KJ, Blease K, Moreno J, Boddicker A, Zhao J, Lajoie B, Scott RT, Altomare A, Kruglyak S, Levy S, Church G, Mason CE. Viral activation and ecological restructuring characterize a microbiome axis of spaceflight-associated immune activation. Res Sq 2023:rs.3.rs-2493867. [PMID: 37886447 PMCID: PMC10602132 DOI: 10.21203/rs.3.rs-2493867/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Maintenance of astronaut health during spaceflight will require monitoring and potentially modulating their microbiomes, which play a role in some space-derived health disorders. However, documenting the response of microbiota to spaceflight has been difficult thus far due to mission constraints that lead to limited sampling. Here, we executed a six-month longitudinal study centered on a three-day flight to quantify the high-resolution microbiome response to spaceflight. Via paired metagenomics and metatranscriptomics alongside single immune profiling, we resolved a microbiome "architecture" of spaceflight characterized by time-dependent and taxonomically divergent microbiome alterations across 750 samples and ten body sites. We observed pan-phyletic viral activation and signs of persistent changes that, in the oral microbiome, yielded plaque-associated pathobionts with strong associations to immune cell gene expression. Further, we found enrichments of microbial genes associated with antibiotic production, toxin-antitoxin systems, and stress response enriched universally across the body sites. We also used strain-level tracking to measure the potential propagation of microbial species from the crew members to each other and the environment, identifying microbes that were prone to seed the capsule surface and move between the crew. Finally, we identified associations between microbiome and host immune cell shifts, proposing both a microbiome axis of immune changes during flight as well as the sources of some of those changes. In summary, these datasets and methods reveal connections between crew immunology, the microbiome, and their likely drivers and lay the groundwork for future microbiome studies of spaceflight.
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Affiliation(s)
- Braden T. Tierney
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - JangKeun Kim
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Eliah G. Overbey
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Krista A. Ryon
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - Jonathan Foox
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - Maria Sierra
- Tri-Institutional Biology and Medicine program, Weill Cornell Medicine, New York, NY, USA
| | - Chandrima Bhattacharya
- Tri-Institutional Biology and Medicine program, Weill Cornell Medicine, New York, NY, USA
| | - Namita Damle
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - Deena Najjar
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - Jiwoon Park
- Tri-Institutional Biology and Medicine program, Weill Cornell Medicine, New York, NY, USA
| | | | - Nadia Houerbi
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Cem Meydan
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Jeremy Wain Hershberg
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Jake Qiu
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - Ashley Kleinman
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Matthew MacKay
- Tri-Institutional Biology and Medicine program, Weill Cornell Medicine, New York, NY, USA
| | - Evan E Afshin
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Raja Dhir
- Seed Health, Inc, Venice, CA, USA
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Joseph Borg
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida, MSD2090, Malta
| | - Christine Gatt
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida, MSD2090, Malta
| | - Nicholas Brereton
- School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Ben Readhead
- ASU-Banner Neurodegenerative Disease Research Center, Arizona State University, Tempe, AZ, USA
| | - Semir Beyaz
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | | | | | | | | | | | | | - Ryan T. Scott
- KBR; Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, USA
| | | | | | | | - George Church
- Harvard Medical School and the Wyss Institute, Boston, MA, USA
| | - Christopher E. Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
- The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, USA
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Abernathy L, Tocci SA, Scott RT. The Posttraumatic Tarsometatarsal Joints. Clin Podiatr Med Surg 2023; 40:581-592. [PMID: 37716738 DOI: 10.1016/j.cpm.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Tarsometatarsal joint injuries can be painful and debilitating and are most commonly due to direct or indirect trauma. Posttraumatic arthritis is a well-known long-term complication, with incidence as high as 58%. Conservative treatment options include shoe modifications, orthotic inserts, topical or oral anti-inflammatories, and intra-articular corticosteroid injections. There are various joint prep and fixation techniques reported in the literature, many with positive clinical and radiographic outcomes. This article discusses nonoperative and operative management of posttraumatic tarsometatarsal joint arthritis, reviews available literature, and includes the authors' tips and techniques.
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Affiliation(s)
- Lant Abernathy
- The CORE Institute Advanced Foot and Ankle Reconstruction Fellowship, The CORE Institute, 9321 W Thomas Road Suite 205, Phoenix, AZ 85037, USA.
| | - Steven A Tocci
- The CORE Institute Advanced Foot and Ankle Reconstruction Fellowship, The CORE Institute, 9321 W Thomas Road Suite 205, Phoenix, AZ 85037, USA
| | - Ryan T Scott
- The CORE Institute Advanced Foot and Ankle Reconstruction Fellowship, The CORE Institute, 9321 W Thomas Road Suite 205, Phoenix, AZ 85037, USA
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5
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Schmied C, Nelson MS, Avilov S, Bakker GJ, Bertocchi C, Bischof J, Boehm U, Brocher J, Carvalho M, Chiritescu C, Christopher J, Cimini BA, Conde-Sousa E, Ebner M, Ecker R, Eliceiri K, Fernandez-Rodriguez J, Gaudreault N, Gelman L, Grunwald D, Gu T, Halidi N, Hammer M, Hartley M, Held M, Jug F, Kapoor V, Koksoy AA, Lacoste J, Dévédec SL, Guyader SL, Liu P, Martins GG, Mathur A, Miura K, Montero Llopis P, Nitschke R, North A, Parslow AC, Payne-Dwyer A, Plantard L, Ali R, Schroth-Diez B, Schütz L, Scott RT, Seitz A, Selchow O, Sharma VP, Spitaler M, Srinivasan S, Strambio-De-Castillia C, Taatjes D, Tischer C, Jambor HK. Community-developed checklists for publishing images and image analyses. ArXiv 2023:arXiv:2302.07005v2. [PMID: 36824427 PMCID: PMC9949169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Images document scientific discoveries and are prevalent in modern biomedical research. Microscopy imaging in particular is currently undergoing rapid technological advancements. However for scientists wishing to publish the obtained images and image analyses results, there are to date no unified guidelines. Consequently, microscopy images and image data in publications may be unclear or difficult to interpret. Here we present community-developed checklists for preparing light microscopy images and image analysis for publications. These checklists offer authors, readers, and publishers key recommendations for image formatting and annotation, color selection, data availability, and for reporting image analysis workflows. The goal of our guidelines is to increase the clarity and reproducibility of image figures and thereby heighten the quality and explanatory power of microscopy data is in publications.
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Affiliation(s)
- Christopher Schmied
- Fondazione Human Technopole, Viale Rita Levi-Montalcini 1, 20157 Milano, Italy
- Present address: Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP), Robert-Rössle-Str. 10, 13125 Berlin, Germany
| | - Michael S Nelson
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Sergiy Avilov
- Max Planck Institute of Immunobiology and Epigenetics, 79108 Freiburg, Germany
| | - Gert-Jan Bakker
- Medical BioSciences department, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Cristina Bertocchi
- Laboratory for Molecular mechanics of cell adhesions, Pontificia Universidad Católica de Chile Santiago
- Osaka University, Graduate School of Engineering Science, Japan
| | - Johanna Bischof
- Euro-BioImaging ERIC, Bio-Hub, Meyerhofstr. 1, 69117 Heidelberg, Germany
| | - Ulrike Boehm
- Carl Zeiss AG, Carl-Zeiss-Straße 22, 73447 Oberkochen, Germany
| | - Jan Brocher
- BioVoxxel, Scientific Image Processing and Analysis, Eugen-Roth-Strasse 8, 67071 Ludwigshafen, Germany
| | - Mariana Carvalho
- Nanophotonics and BioImaging Facility at INL, International Iberian Nanotechnology Laboratory, 4715-330, Portugal
| | | | | | - Beth A Cimini
- Imaging Platform, Broad Institute, Cambridge, MA 02142
| | - Eduardo Conde-Sousa
- i3S, Instituto de Investigação e Inovação Em Saúde and INEB, Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Michael Ebner
- Fondazione Human Technopole, Viale Rita Levi-Montalcini 1, 20157 Milano, Italy
| | - Rupert Ecker
- Translational Research Institute, Queensland University of Technology, 37 Kent Street, Woolloongabba, QLD 4102, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
- TissueGnostics GmbH, 1020 Vienna, Austria
| | - Kevin Eliceiri
- Department of Medical Physics and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | | | | | - Laurent Gelman
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - David Grunwald
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, MA 01605, USA
| | | | - Nadia Halidi
- Advanced Light Microscopy Unit, Centre for Genomic Regulation, Barcelona, Spain
| | - Mathias Hammer
- RNA Therapeutics Institute, University of Massachusetts Chan Medical School, Worcester, MA 01605, USA
| | - Matthew Hartley
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Hinxton, UK
| | - Marie Held
- Centre for Cell Imaging, The University of Liverpool, UK
| | - Florian Jug
- Fondazione Human Technopole, Viale Rita Levi-Montalcini 1, 20157 Milano, Italy
| | - Varun Kapoor
- Department of AI research, Kapoor Labs, Paris, 75005, France
| | | | | | - Sylvia Le Dévédec
- Division of Drug Discovery and Safety, Cell Observatory, Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
| | | | - Penghuan Liu
- Key Laboratory for Modern Measurement Technology and Instruments of Zhejiang Province, College of Optical and Electronic Technology, China Jiliang University, Hangzhou, China
| | - Gabriel G Martins
- Advanced Imaging Facility, Instituto Gulbenkian de Ciência, Oeiras 2780-156 - Portugal
| | - Aastha Mathur
- Euro-BioImaging ERIC, Bio-Hub, Meyerhofstr. 1, 69117 Heidelberg, Germany
| | - Kota Miura
- Bioimage Analysis & Research, 69127 Heidelberg/Germany
| | | | - Roland Nitschke
- Life Imaging Center, Signalling Research Centres CIBSS and BIOSS, University of Freiburg, Germany
| | - Alison North
- Bio-Imaging Resource Center, The Rockefeller University, New York, NY USA
| | - Adam C Parslow
- Baker Institute Microscopy Platform, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
| | - Alex Payne-Dwyer
- School of Physics, Engineering and Technology, University of York, Heslington, YO10 5DD, UK
| | - Laure Plantard
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Rizwan Ali
- King Abdullah International Medical Research Center (KAIMRC), Medical Research Core Facility and Platforms (MRCFP), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh 11481, Saudi Arabia
| | - Britta Schroth-Diez
- Light Microscopy Facility, Max Planck Institute of Molecular Cell Biology and Genetics Dresden, Pfotenhauerstrasse 108, 01307 Dresden, Germany
| | - Lucas Schütz
- ariadne.ai (Germany) GmbH, 69115 Heidelberg, Germany
| | - Ryan T Scott
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, 94035, USA
| | - Arne Seitz
- BioImaging & Optics Platform (BIOP), Ecole Polytechnique Fédérale de Lausanne (EPFL), Faculty of Life sciences (SV), CH-1015 Lausanne
| | - Olaf Selchow
- Microscopy & BioImaging Consulting, Image Processing & Large Data Handling, Tobias-Hoppe-Strassse 3, 07548 Gera, Germany
| | - Ved P Sharma
- Bio-Imaging Resource Center, The Rockefeller University, New York, NY USA
| | - Martin Spitaler
- Max Planck Institute of Biochemistry, Am Klopferspitz 18, 82152 Martinsried, Germany
| | - Sathya Srinivasan
- Imaging and Morphology Support Core, Oregon National Primate Research Center - (ONPRC - OHSU West Campus), Beaverton, Oregon 97006, USA
| | | | - Douglas Taatjes
- Department of Pathology and Laboratory Medicine, Microscopy Imaging Center (RRID# SCR_018821), Center for Biomedical Shared Resources, University of Vermont, Burlington, VT 05405 USA
| | - Christian Tischer
- Centre for Bioimage Analysis, EMBL Heidelberg, Meyerhofstr. 1, 69117 Heidelberg, Germany
| | - Helena Klara Jambor
- NCT-UCC, Medizinische Fakultät TU Dresden, Fetscherstrasse 105, 01307 Dresden/Germany
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6
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So E, Juels C, Scott RT, Sietsema DL. A Comparison of Ankle Fractures Relative to Other Fragility Fractures: A Review and Analysis of the American Orthopaedic Association's Own the Bone Database. Foot Ankle Int 2023; 44:879-887. [PMID: 37300238 DOI: 10.1177/10711007231178536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Ankle fragility fractures (AFX) continue to increase in the elderly population. There is limited knowledge of AFX characteristics compared to nonankle fragility fractures (NAFX). The American Orthopaedic Association's Own the Bone (OTB) is a fragility fracture initiative. This robust data set was used to examine and compare characteristics of patients presenting with AFX to those with NAFX. METHODS The OTB database contained 72,617 fragility fractures between January 2009 and March of 2022 and were reviewed in our secondary cohort comparative analysis. After exclusions, AFX accounted for 3229 patients and 54,772 patients were in the NAFX cohort. Bivariate analysis and logistic regression compared the AFX and NAFX groups concerning demographics, bone health factors, medication use, and prior fragility fracture. RESULTS AFX patients were found to have a higher likelihood to be younger (67.6 years old), female (81.4%), non-Caucasian (11.7%) and have a higher BMI (30.6) compared to NAFX. Prior AFX predicted the risk of a future AFX. The probability of an AFX increased with increased age and BMI. CONCLUSION A prior AFX is independently predictive of subsequent AFX. Therefore, these fractures should be considered a sentinel event. These patients are more likely to have higher BMI, to be of female gender, non-Caucasian race, and are younger compared to patients with NAFX. LEVEL OF EVIDENCE Level III, retrospective cohort.
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Affiliation(s)
- Eric So
- Capital Foot and Ankle - Bryan Physician Network, Lincoln, NE, USA
| | | | | | - Debra L Sietsema
- The CORE Institute (retired), Phoenix, AZ, USA
- MORE Foundation (retired), Phoenix, AZ, USA
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Wolfe J, Derner B, Scott RT. Management of Subchondral Lesions in the Foot and Ankle. Clin Podiatr Med Surg 2023; 40:553-568. [PMID: 37236691 DOI: 10.1016/j.cpm.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The treatment of subchondral lesions is an area with limited focus within the foot and ankle literature. The literature has shown an association between disruption of the subchondral bone plate and the formation of subchondral cysts. The primary causes of subchondral lesions are acute trauma, repetitive microtrauma, as well as idiopathic means. Evaluation of these injuries should be done carefully and often requires advanced imaging including MRI and computed tomography. Treatment does vary depending on the presentation of the subchondral lesion with or without the presence of an osteochondral lesion.
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Affiliation(s)
- Joshua Wolfe
- The CORE Institute Reconstructive Foot and Ankle Fellowship, The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA.
| | - Brian Derner
- The CORE Institute Reconstructive Foot and Ankle Fellowship, The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA
| | - Ryan T Scott
- The CORE Institute Reconstructive Foot and Ankle Fellowship, The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA
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Sanders LM, Scott RT, Yang JH, Qutub AA, Garcia Martin H, Berrios DC, Hastings JJA, Rask J, Mackintosh G, Hoarfrost AL, Chalk S, Kalantari J, Khezeli K, Antonsen EL, Babdor J, Barker R, Baranzini SE, Beheshti A, Delgado-Aparicio GM, Glicksberg BS, Greene CS, Haendel M, Hamid AA, Heller P, Jamieson D, Jarvis KJ, Komarova SV, Komorowski M, Kothiyal P, Mahabal A, Manor U, Mason CE, Matar M, Mias GI, Miller J, Myers JG, Nelson C, Oribello J, Park SM, Parsons-Wingerter P, Prabhu RK, Reynolds RJ, Saravia-Butler A, Saria S, Sawyer A, Singh NK, Snyder M, Soboczenski F, Soman K, Theriot CA, Van Valen D, Venkateswaran K, Warren L, Worthey L, Zitnik M, Costes SV. Biological research and self-driving labs in deep space supported by artificial intelligence. NAT MACH INTELL 2023. [DOI: 10.1038/s42256-023-00618-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Scott RT, Sanders LM, Antonsen EL, Hastings JJA, Park SM, Mackintosh G, Reynolds RJ, Hoarfrost AL, Sawyer A, Greene CS, Glicksberg BS, Theriot CA, Berrios DC, Miller J, Babdor J, Barker R, Baranzini SE, Beheshti A, Chalk S, Delgado-Aparicio GM, Haendel M, Hamid AA, Heller P, Jamieson D, Jarvis KJ, Kalantari J, Khezeli K, Komarova SV, Komorowski M, Kothiyal P, Mahabal A, Manor U, Garcia Martin H, Mason CE, Matar M, Mias GI, Myers JG, Nelson C, Oribello J, Parsons-Wingerter P, Prabhu RK, Qutub AA, Rask J, Saravia-Butler A, Saria S, Singh NK, Snyder M, Soboczenski F, Soman K, Van Valen D, Venkateswaran K, Warren L, Worthey L, Yang JH, Zitnik M, Costes SV. Biomonitoring and precision health in deep space supported by artificial intelligence. NAT MACH INTELL 2023. [DOI: 10.1038/s42256-023-00617-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Overbey EG, Das S, Cope H, Madrigal P, Andrusivova Z, Frapard S, Klotz R, Bezdan D, Gupta A, Scott RT, Park J, Chirko D, Galazka JM, Costes SV, Mason CE, Herranz R, Szewczyk NJ, Borg J, Giacomello S. Challenges and considerations for single-cell and spatially resolved transcriptomics sample collection during spaceflight. Cell Rep Methods 2022; 2:100325. [PMID: 36452864 PMCID: PMC9701605 DOI: 10.1016/j.crmeth.2022.100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Single-cell RNA sequencing (scRNA-seq) and spatially resolved transcriptomics (SRT) have experienced rapid development in recent years. The findings of spaceflight-based scRNA-seq and SRT investigations are likely to improve our understanding of life in space and our comprehension of gene expression in various cell systems and tissue dynamics. However, compared to their Earth-based counterparts, gene expression experiments conducted in spaceflight have not experienced the same pace of development. Out of the hundreds of spaceflight gene expression datasets available, only a few used scRNA-seq and SRT. In this perspective piece, we explore the growing importance of scRNA-seq and SRT in space biology and discuss the challenges and considerations relevant to robust experimental design to enable growth of these methods in the field.
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Affiliation(s)
- Eliah G. Overbey
- Weill Cornell Medicine, New York, NY, USA
- Institute for Computational Biomedicine, New York, NY, USA
| | - Saswati Das
- Department of Biochemistry, Atal Bihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Henry Cope
- School of Medicine, University of Nottingham, Derby DE22 3DT, UK
| | - Pedro Madrigal
- European Molecular Biology Laboratory, European Bioinformatics Institute, EMBL-EBI, Wellcome Genome Campus, Hinxton, UK
| | - Zaneta Andrusivova
- Science for Life Laboratory, Department of Gene Technology, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Solène Frapard
- Science for Life Laboratory, Department of Gene Technology, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Rebecca Klotz
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Daniela Bezdan
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen 72076, Germany
- NGS Competence Center Tübingen (NCCT), University of Tübingen, Tübingen, German
- yuri GmbH, Meckenbeuren, Germany
| | | | - Ryan T. Scott
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | | | | | - Jonathan M. Galazka
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Sylvain V. Costes
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Christopher E. Mason
- Weill Cornell Medicine, New York, NY, USA
- Institute for Computational Biomedicine, New York, NY, USA
- The Feil Family Brain and Mind Research Institute, New York, NY, USA
- The WorldQuant Initiative for Quantitative Prediction, New York, NY, USA
| | - Raul Herranz
- Centro de Investigaciones Biológicas Margarita Salas (CSIC), Madrid 28040, Spain
| | - Nathaniel J. Szewczyk
- School of Medicine, University of Nottingham, Derby DE22 3DT, UK
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - Joseph Borg
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Stefania Giacomello
- Science for Life Laboratory, Department of Gene Technology, KTH Royal Institute of Technology, Stockholm, Sweden
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Reynolds RJ, Scott RT, Turner RT, Iwaniec UT, Bouxsein ML, Sanders LM, Antonsen EL. Validating Causal Diagrams of Human Health Risks for Spaceflight: An Example Using Bone Data from Rodents. Biomedicines 2022; 10:2187. [PMID: 36140288 PMCID: PMC9496259 DOI: 10.3390/biomedicines10092187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 12/24/2022] Open
Abstract
As part of the risk management plan for human system risks at the US National Aeronautics and Space Administration (NASA), the NASA Human Systems Risk Board uses causal diagrams (in the form of directed, acyclic graphs, or DAGs) to communicate the complex web of events that leads from exposure to the spaceflight environment to performance and health outcomes. However, the use of DAGs in this way is relatively new at NASA, and thus far, no method has been articulated for testing their veracity using empirical data. In this paper, we demonstrate a set of procedures for doing so, using (a) a DAG related to the risk of bone fracture after exposure to spaceflight; and (b) four datasets originally generated to investigate this phenomenon in rodents. Tests of expected marginal correlation and conditional independencies derived from the DAG indicate that the rodent data largely agree with the structure of the diagram. Incongruencies between tests and the expected relationships in one of the datasets are likely explained by inadequate representation of a key DAG variable in the dataset. Future directions include greater tie-in with human data sources, including multiomics data, which may allow for more robust characterization and measurement of DAG variables.
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Affiliation(s)
- Robert J. Reynolds
- KBR Wyle Services, LLC, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Ryan T. Scott
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94043, USA
| | - Russell T. Turner
- Skeletal Biology Laboratory, Oregon State University, Corvallis, OR 97331, USA
| | - Urszula T. Iwaniec
- Skeletal Biology Laboratory, Oregon State University, Corvallis, OR 97331, USA
| | - Mary L. Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - Lauren M. Sanders
- Blue Marble Space Institute of Science, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94043, USA
| | - Erik L. Antonsen
- Department of Emergency Medicine, Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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12
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So E, Juels CA, Seidenstricker C, Walker R, Scott RT. Postoperative Infection Rates After Total Ankle Arthroplasty: A Comparison With and Without the Use of a Surgical Helmet System. J Foot Ankle Surg 2022; 61:802-806. [PMID: 34974981 DOI: 10.1053/j.jfas.2021.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 10/17/2021] [Accepted: 11/29/2021] [Indexed: 02/03/2023]
Abstract
Following total joint arthroplasty, surgical site infections (SSI) and periprosthetic joint infections (PJI) are associated with increased patient morbidity and healthcare utilization. Current positive-pressure surgical sterile helmet system (SHS) were developed as a feasible, useful version of the body exhaust system.The use of SHS has not yet been proven to decrease infection rates in the orthopedic literature. The primary purpose of this study is to compare the infection rates between patients who underwent total ankle arthroplasty (TAA) with a surgical team wearing SHS versus without SHS.A retrospective chart review in patients undergoing primary TAA with the surgeon wearing SHS (Group 1) or standard surgical attire (Group 2) was conducted. The primary outcome was postoperative SSI and PJI. The rate of wound complications, revision rates, and associated procedures were also analyzed. We identified 109 patients in Group 1 and 151 patients in Group 2. The rate of SSI was 12.8% in Group 1 and 14.6% in Group 2 (p = .411). The rate of PJI was 0.92% in Group 1 and 2.6% in Group 2 (p = .411). There was no difference in revision rates between the two groups. This study suggests that SHS does not appear to protect against postoperative SSI or PJI after TAA. Conversely, we did not find a higher infection rate compared to standard surgical attire despite recent in-vitro studies suggesting SHS as a source of wound contamination. The utility of SHS does not appear to influence the prevalence of postoperative SSI or PJI.
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Affiliation(s)
- Eric So
- Bryan Health, Lincoln, NE; Ohio Innovation Group, Columbus, OH.
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13
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Afshinnekoo E, Scott RT, MacKay MJ, Pariset E, Cekanaviciute E, Barker R, Gilroy S, Hassane D, Smith SM, Zwart SR, Nelman-Gonzalez M, Crucian BE, Ponomarev SA, Orlov OI, Shiba D, Muratani M, Yamamoto M, Richards SE, Vaishampayan PA, Meydan C, Foox J, Myrrhe J, Istasse E, Singh N, Venkateswaran K, Keune JA, Ray HE, Basner M, Miller J, Vitaterna MH, Taylor DM, Wallace D, Rubins K, Bailey SM, Grabham P, Costes SV, Mason CE, Beheshti A. Fundamental Biological Features of Spaceflight: Advancing the Field to Enable Deep-Space Exploration. Cell 2021; 184:6002. [PMID: 34822785 DOI: 10.1016/j.cell.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Juels CA, So E, Seidenstricker C, Holmes J, Scott RT. A Comparison of Outcomes of Revision Surgical Options for the Treatment of Failed Bulk Talar Allograft Transfer: A Systematic Review. J Foot Ankle Surg 2021; 59:1265-1271. [PMID: 32972848 DOI: 10.1053/j.jfas.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/27/2020] [Accepted: 07/14/2020] [Indexed: 02/03/2023]
Abstract
Talar bulk osteochondral allograft transplantation is a useful treatment strategy for large, uncontained osteochondral lesions of talus. Complications and high revision rates from osteochondral talar allograft transfer can be common. Talar graft failure is a devastating complication that results from failure of allograft incorporation within the host bone and subsequent resorption and sometimes subsidence can occur. Treatment options and outcomes for graft failure have rarely been reported. The purpose of this study is to evaluate treatment options and their outcomes for treating talar allograft failure. A systematic review was completed to find all reports of salvage treatments for talar graft failure and outcomes of these reports were analyzed. Eleven studies involving a total of 522 ankles, in 520 patients, met the inclusion criteria. The allograft failure rate was 11.5% in these studies with a reoperation rate of 18.9%. With limited reports, satisfactory outcomes for treatment of graft failure with ankle arthrodesis were 77.3%, 50% for revision allograft procedures, and 50% for total ankle arthroplasty. Considering the large failure rate and reoperation rate for bulk talar allograft transplantations, superior revision, and salvage options are needed. More prospective cohort studies focusing on consistent and standard outcome measures are needed to further assess revision options for failed talar allograft procedures.
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Affiliation(s)
- Christopher A Juels
- Fellow, The CORE Institute Foot and Ankle Advanced Reconstruction Fellowship, Phoenix, AZ.
| | - Eric So
- Fellow, The CORE Institute Foot and Ankle Advanced Reconstruction Fellowship, Phoenix, AZ
| | | | | | - Ryan T Scott
- Director, The CORE Institute Foot and Ankle Advanced Reconstruction Fellowship, Phoenix, AZ
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15
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Afshinnekoo E, Scott RT, MacKay MJ, Pariset E, Cekanaviciute E, Barker R, Gilroy S, Hassane D, Smith SM, Zwart SR, Nelman-Gonzalez M, Crucian BE, Ponomarev SA, Orlov OI, Shiba D, Muratani M, Yamamoto M, Richards SE, Vaishampayan PA, Meydan C, Foox J, Myrrhe J, Istasse E, Singh N, Venkateswaran K, Keune JA, Ray HE, Basner M, Miller J, Vitaterna MH, Taylor DM, Wallace D, Rubins K, Bailey SM, Grabham P, Costes SV, Mason CE, Beheshti A. Fundamental Biological Features of Spaceflight: Advancing the Field to Enable Deep-Space Exploration. Cell 2021; 183:1162-1184. [PMID: 33242416 DOI: 10.1016/j.cell.2020.10.050] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 12/14/2022]
Abstract
Research on astronaut health and model organisms have revealed six features of spaceflight biology that guide our current understanding of fundamental molecular changes that occur during space travel. The features include oxidative stress, DNA damage, mitochondrial dysregulation, epigenetic changes (including gene regulation), telomere length alterations, and microbiome shifts. Here we review the known hazards of human spaceflight, how spaceflight affects living systems through these six fundamental features, and the associated health risks of space exploration. We also discuss the essential issues related to the health and safety of astronauts involved in future missions, especially planned long-duration and Martian missions.
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Affiliation(s)
- Ebrahim Afshinnekoo
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Ryan T Scott
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Matthew J MacKay
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Eloise Pariset
- Universities Space Research Association (USRA), Mountain View, CA 94043, USA; Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Egle Cekanaviciute
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Richard Barker
- Department of Botany, University of Wisconsin, Madison, WI 53706, USA
| | - Simon Gilroy
- Department of Botany, University of Wisconsin, Madison, WI 53706, USA
| | | | - Scott M Smith
- Human Health and Performance Directorate, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Sara R Zwart
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Mayra Nelman-Gonzalez
- KBR, Human Health and Performance Directorate, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Brian E Crucian
- Human Health and Performance Directorate, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Sergey A Ponomarev
- Institute for the Biomedical Problems, Russian Academy of Sciences, 123007 Moscow, Russia
| | - Oleg I Orlov
- Institute for the Biomedical Problems, Russian Academy of Sciences, 123007 Moscow, Russia
| | - Dai Shiba
- JEM Utilization Center, Human Spaceflight Technology Directorate, Japan Aerospace Exploration Agency (JAXA), Ibaraki 305-8505, Japan
| | - Masafumi Muratani
- Transborder Medical Research Center, and Department of Genome Biology, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan
| | - Stephanie E Richards
- Bionetics, NASA Kennedy Space Center, Kennedy Space Center, Merritt Island, FL 32899, USA
| | - Parag A Vaishampayan
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Cem Meydan
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Jonathan Foox
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Jacqueline Myrrhe
- European Space Agency, Research and Payloads Group, Data Exploitation and Utilisation Strategy Office, 2200 AG Noordwijk, the Netherlands
| | - Eric Istasse
- European Space Agency, Research and Payloads Group, Data Exploitation and Utilisation Strategy Office, 2200 AG Noordwijk, the Netherlands
| | - Nitin Singh
- Biotechnology and Planetary Protection Group, Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - Kasthuri Venkateswaran
- Biotechnology and Planetary Protection Group, Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - Jessica A Keune
- Space Medicine Operations Division, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Hami E Ray
- ASRC Federal Space and Defense, Inc., Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Mathias Basner
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Jack Miller
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Martha Hotz Vitaterna
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL 60208, USA; Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Deanne M Taylor
- Department of Biomedical Informatics, The Children's Hospital of Philadelphia, PA 19104, USA; Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; The Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Douglas Wallace
- Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; The Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kathleen Rubins
- Astronaut Office, NASA Johnson Space Center, Houston, TX 77058, USA
| | - Susan M Bailey
- Department of Environmental & Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA.
| | - Peter Grabham
- Center for Radiological Research, Department of Oncology, College of Physicians and Surgeons, Columbia University, New York, NY 10027, USA.
| | - Sylvain V Costes
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA.
| | - Christopher E Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10021, USA; WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA; The Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, NY 10021, USA.
| | - Afshin Beheshti
- KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
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16
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Osman EK, Wang T, Zhan Y, Juneau CR, Morin SJ, Seli E, Scott RT, Franasiak JM. Varying levels of serum estradiol do not alter the timing of the early endometrial secretory transformation. Hum Reprod 2021; 35:1637-1647. [PMID: 32613240 DOI: 10.1093/humrep/deaa135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/06/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Do supraphysiologic estradiol (E2) levels in the ranges attained during normal and high response superovulation cycles modify the onset of endometrial secretory transformation? SUMMARY ANSWER Highly supraphysiologic levels of E2 do not alter the ability of physiologic levels of progesterone (P4) to induce secretory transformation. WHAT IS KNOWN ALREADY Previous studies have demonstrated that premature P4 elevations during IVF cycles are associated with a decrement in clinical pregnancy rates after fresh embryo transfer due to shifts in the window of implantation (WOI). However, alterations in the onset of secretory transformation may not apply uniformly to all patients. High responders with supraphysiologic E2 levels accompanied by similar subtle increases in P4 have not been shown to have decreased sustained implantation rates. This prospective investigation in which whole-genome transcriptomic and methylomic analysis of the endometrium is performed for individual patients under a range of E2 concentrations brings clarity to a long-debated issue. STUDY DESIGN, SIZE, DURATION A randomized, prospective and paired trial was conducted in which 10 participants were enrolled and randomized to the order in which they completed three distinct uterine stimulation cycles, each at a specific E2 concentration: physiologic (∼180 pg/ml), moderately supraphysiologic (600-800 pg/ml) or supraphysiologic (2000 pg/ml). Target E2 ranges were selected to mimic those seen in natural, controlled ovarian stimulation and IVF cycles. E2 valerate was administered in order to maintain stable E2 levels for 12 days followed by intramuscular P4 in oil 10 mg/day for two doses, after which an endometrial biopsy was performed. A total of 30 endometrial biopsies were included in a whole-genome transcriptomic and methylomic analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Healthy volunteers without a history of infertility were included in this study at a single large infertility center. DNA was isolated from the endometrial biopsy specimens and bisulfite sequencing was performed to construct a methylation array. Differential methylation analysis was conducted based on differences in M-values of individuals across treatment groups for each probe as well as carrying out t-tests. RNA was isolated for RNA-Seq analysis and gene expression values were compared using DESeq2. All analyses were performed in a pairwise fashion to compare among the three stimulation cycles within individuals and secondarily to compare all participants in each of the cycles. MAIN RESULTS AND THE ROLE OF CHANCE The mean peak E2 and P4 levels were 275 pg/ml and 4.17 ng/ml in the physiologic group, 910 pg/ml and 2.69 ng/ml in the moderate group was, and 2043 pg/ml and 2.64 ng/ml in the supraphysiologic group, respectively. Principal component analysis of 834 913 CpG sites was performed on M-values of individuals within the low, moderate and supraphysiologic conditions in a paired approach. There were no differences in genome-wide methylation within participants across E2 groups. A paired analysis revealed that gene expression profiles did not differ within the same individual at each of the three E2 levels. No significant alterations in gene expression as related to endometrial physiology were identified between the low, moderate and supraphysiologic groups in an inter-participant analysis. LIMITATIONS, REASONS FOR CAUTION Although each participant completed a physiologic cycle in which E2 levels were maintained in a range that would simulate a natural cycle, our findings are limited by lack of an unmedicated control to assess if there was a potential effect from E2V. Additionally, our results were obtained in fertile individuals, who may have a different endometrial response compared to an infertile population. Despite the whole genomic endometrial assessment and rigorous, paired study design, the sample size was limited. WIDER IMPLICATIONS OF THE FINDINGS Given that the endometrial response to P4 is unaffected by E2 levels in the supraphysiologic range, diminutions in implantation seen in stimulated cycles may result from embryonic-endometrial dyssynchrony following early P4 elevations or slowly blastulating embryos, which occur independently of the magnitude of the E2 rise. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Foundation for Embryonic Competence, Basking Ridge, NJ, USA. Dr E.S. reports consultancy work for The Foundation for Embryonic Competence, Basking Ridge, NJ, USA. The other authors declare no conflict of interests related to this topic. TRIAL REGISTRATION NUMBER NCT02458404.
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Affiliation(s)
- E K Osman
- IVI-RMA New Jersey, Basking Ridge, NJ, USA
| | - T Wang
- The Foundation for Embryonic Competence, Basking Ridge, NJ, USA
| | - Y Zhan
- The Foundation for Embryonic Competence, Basking Ridge, NJ, USA
| | | | - S J Morin
- IVI-RMA Northern California, San Francisco, CA, USA
| | - E Seli
- IVI-RMA New Jersey, Basking Ridge, NJ, USA.,Yale University School of Medicine, New Haven, CT, USA
| | - R T Scott
- IVI-RMA New Jersey, Basking Ridge, NJ, USA
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17
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Piraino JA, Theodoulou MH, Ortiz J, Peterson K, Lundquist A, Hollawell S, Scott RT, Joseph R, Mahan KT, Bresnahan PJ, Butto DN, Cain JD, Ford TC, Knight JM, Wobst GM. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Appropriate Clinical Management of Adult-Acquired Flatfoot Deformity. J Foot Ankle Surg 2021; 59:347-355. [PMID: 32131002 DOI: 10.1053/j.jfas.2019.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This clinical consensus statement of the American College of Foot and Ankle Surgeons focuses on the highly debated subject of the management of adult flatfoot (AAFD). In developing this statement, the AAFD consensus statement panel attempted to address the most relevant issues facing the foot and ankle surgeon today, using the best evidence-based literature available. The panel created and researched 16 statements and generated opinions on the appropriateness of the statements. The results of the research on this topic and the opinions of the panel are presented here.
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Affiliation(s)
- Jason A Piraino
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL.
| | - Michael H Theodoulou
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Julio Ortiz
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Kyle Peterson
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Andrew Lundquist
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Shane Hollawell
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Ryan T Scott
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Robert Joseph
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Kieran T Mahan
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Philip J Bresnahan
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Danielle N Butto
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Jarrett D Cain
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Timothy C Ford
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Jessica Marie Knight
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
| | - Garrett M Wobst
- Adult-Acquired Flatfoot Deformity Clinical Consensus Statement Panel of the American College of Foot and Ankle Surgeons, Chicago, IL
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18
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Nelson CA, Acuna AU, Paul AM, Scott RT, Butte AJ, Cekanaviciute E, Baranzini SE, Costes SV. Knowledge Network Embedding of Transcriptomic Data from Spaceflown Mice Uncovers Signs and Symptoms Associated with Terrestrial Diseases. Life (Basel) 2021; 11:life11010042. [PMID: 33445483 PMCID: PMC7828077 DOI: 10.3390/life11010042] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
There has long been an interest in understanding how the hazards from spaceflight may trigger or exacerbate human diseases. With the goal of advancing our knowledge on physiological changes during space travel, NASA GeneLab provides an open-source repository of multi-omics data from real and simulated spaceflight studies. Alone, this data enables identification of biological changes during spaceflight, but cannot infer how that may impact an astronaut at the phenotypic level. To bridge this gap, Scalable Precision Medicine Oriented Knowledge Engine (SPOKE), a heterogeneous knowledge graph connecting biological and clinical data from over 30 databases, was used in combination with GeneLab transcriptomic data from six studies. This integration identified critical symptoms and physiological changes incurred during spaceflight.
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Affiliation(s)
- Charlotte A. Nelson
- Integrated Program in Quantitative Biology, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Ana Uriarte Acuna
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; (A.U.A.); (A.M.P.); (R.T.S.); (E.C.)
- KBR, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Amber M. Paul
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; (A.U.A.); (A.M.P.); (R.T.S.); (E.C.)
- NASA Postdoctoral Program, Universities Space Research Association (USRA), Mountain View, CA 94043, USA
| | - Ryan T. Scott
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; (A.U.A.); (A.M.P.); (R.T.S.); (E.C.)
- KBR, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - Atul J. Butte
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA 94143, USA;
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Egle Cekanaviciute
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; (A.U.A.); (A.M.P.); (R.T.S.); (E.C.)
| | - Sergio E. Baranzini
- Integrated Program in Quantitative Biology, University of California San Francisco, San Francisco, CA 94143, USA;
- Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, CA 94143, USA;
- Weill Institute for Neuroscience, Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
- Correspondence: (S.E.B.); (S.V.C.)
| | - Sylvain V. Costes
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA; (A.U.A.); (A.M.P.); (R.T.S.); (E.C.)
- Correspondence: (S.E.B.); (S.V.C.)
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19
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Juels CA, So E, Seidenstricker C, Holmes J, Scott RT. Complications of En Bloc Osteochondral Talar Allografts and Treatment of Failures: Literature Review and Case Report. J Foot Ankle Surg 2020; 59:149-155. [PMID: 31753570 DOI: 10.1053/j.jfas.2019.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 06/20/2019] [Indexed: 02/03/2023]
Abstract
Reoperation rates and complication rates can be high for patients receiving an osteochondral talar allograft transplant. Complications can include graft failure, delamination of the graft, arthrofibrosis, advancing osteoarthritis, nonunion of malleolar osteotomies, and partial or complete osteonecrosis of the talus. Graft failure refers to failure of graft incorporation with subsequent necrosis and subsidence. Treatment options for talar graft failure are limited, and outcomes for these treatments have rarely been reported. We present a review of the published data on the complications and treatments for failed talar allograft transplantation. A case report is presented on a young woman who experienced graft failure and osteonecrosis of her talar allograft transplant. Because of the size of the present osteonecrosis, an ankle arthrodesis was performed as the initial revision procedure. Talar necrosis was removed and revascularized from the ankle fusion with solid fusion was confirmed with computed tomography. Symptomatic adjacent joint pain quickly developed in the hindfoot after the ankle fusion, and 12 months later an ankle fusion conversion to total ankle arthroplasty was performed. The patient has returned to normal activity with significant reduction in pain at most recent follow-up visit. This patient was followed for 7 years from initial osteochondral talar allograft transplantation and for 2 years from conversion of ankle fusion to total ankle arthroplasty. It is important to understand the techniques, indications, and outcomes for the various revision options for talar allograft failure. This case report illustrates how multiple revision options can be used to provide the best outcome for the patient.
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Affiliation(s)
- Christopher A Juels
- Fellow, The CORE Institute Foot and Ankle Advanced Reconstruction Fellowship, Phoenix, AZ.
| | - Eric So
- Fellow, The CORE Institute Foot and Ankle Advanced Reconstruction Fellowship, Phoenix, AZ
| | | | | | - Ryan T Scott
- Director, The CORE Institute Foot and Ankle Advanced Reconstruction Fellowship, Phoenix, AZ
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20
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Morin SJ, Patounakis G, Juneau CR, Neal SA, Scott RT, Seli E. Diminished ovarian reserve and poor response to stimulation in patients <38 years old: a quantitative but not qualitative reduction in performance. Hum Reprod 2020; 33:1489-1498. [PMID: 30010882 DOI: 10.1093/humrep/dey238] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/04/2018] [Accepted: 06/15/2018] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do infertile women aged <38 years with quantitative evidence of diminished ovarian reserve and/or poor response to stimulation also exhibit poor oocyte quality as measured by blastulation rates, aneuploidy rates, and live birth rates? SUMMARY ANSWER Young women with evidence of accelerated follicular depletion, either by precycle ovarian reserve testing or postcycle evidence of low oocyte yield, exhibit equivalent blastulation rates, aneuploidy rates and live birth rates per euploid embryo transfer as age-matched controls with normal precycle and postcycle parameters. WHAT IS KNOWN ALREADY Previous studies are conflicted as to whether women with evidence of diminished ovarian reserve and/or poor ovarian response are also at increased risk of exhibiting evidence of poor oocyte quality. Most prior studies have failed to adequately control for the confounding effect of female age on typical markers of oocyte quality in poor responders. The rate of follicular depletion occurs at around 38 years on average; thus, evidence of quantitative depletion before this would indicate a premature diminution of ovarian reserve and allow evaluation of whether markers of oocyte quality are tied to quantitative markers. STUDY DESIGN, SIZE, DURATION This was a retrospective cohort study at a single center between 2012 and 2016. This time frame was specifically chosen as all embryos were cultured to the blastocyst stage at this center during the study period (no cleavage stage transfers were performed). Two comparisons were made: precycle assessment of ovarian reserve (based on anti-mullerian hormone (AMH) level) and postcycle oocyte yield results. For each comparison, patients in <10th percentile were compared to patients in the interquartile range (IQR) with respect to blastulation rate, aneuploidy rate and live birth rate. A mixed effects model was created to control for female age (in the <38 year old range) and correlation among oocytes from a given cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS For the precycle blastulation analysis, only patients with AMH data available were included (345 patients with AMH in the <10th percentile versus 1758 patients with AMH in the 25th to 75th percentile (IQR)). To compare aneuploidy rates, the subset of these patients who pursued preimplantation genetic testing for aneuploidy (PGT-A) was then analyzed (124 patients in the <10th percentile versus 782 patients in the IQR). For the postcycle blastulation analysis, all patients who proceeded to retrieval (whether or not they also had AMH data available) were included (535 patients with oocyte yield in the <10th percentile versus 2675 patients in the IQR). To compare aneuploidy rates, the subset of these patients who pursued PGT-A was then analyzed (156 patients in the <10th percentile versus 1100 patients in the IQR). MAIN RESULTS AND THE ROLE OF CHANCE The adjusted odds of a given fertilized oocyte developing to a blastocyst, being aneuploid or leading to a live birth after euploid transfer were no different if the oocyte was retrieved from a cycle with ovarian reserve parameters or oocyte yield in the <10th percentile compared to an oocyte retrieved in a cycle with those parameters in the 25-75th percentile. An AMH level in the <10th percentile did more commonly result in cycle cancellation prior to retrieval and after retrieval prior to transfer due to global arrest of embryos. LIMITATIONS, REASONS FOR CAUTION The timing of retrieval in patients with fewer oocytes may be more optimal given the greater ability to discern the overall maturity of the cohort, thus enhancing performance per retrieved oocyte. Analyses included only first cycles. Subsequent adjustment of protocol due to prior performance may mean that some patients in the <10th percentile for oocyte yield are actually better prognosis patients than their first cycle indicates. Data on whether or not patients were on oral contraceptives at time that AMH level drawn was not available. Other unknown biases are also likely to be present given retrospective nature of the study. WIDER IMPLICATIONS OF THE FINDINGS While young women with evidence of quantitative depletion of ovarian reserve have lower live birth rates per stimulation cycle, this not attributable to poor oocyte quality because the blastulation rate per fertilized oocyte and live birth rate per embryo transfer are equivalent to that in women with normal quantitative markers of ovarian reserve. Thus, the pathophysiology mediating a premature quantitative decline in ovarian reserve appears different than that which mediates markers of oocyte quality, such as aneuploidy. Young poor responders may use this information to help guide embryo accumulation strategies when considering their family building plans. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S J Morin
- IVI RMA New Jersey, Basking Ridge, NJ, USA.,Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - C R Juneau
- IVI RMA New Jersey, Basking Ridge, NJ, USA
| | - S A Neal
- IVI RMA New Jersey, Basking Ridge, NJ, USA.,Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - R T Scott
- IVI RMA New Jersey, Basking Ridge, NJ, USA.,Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - E Seli
- IVI RMA New Jersey, Basking Ridge, NJ, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
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21
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Scott RT, Talburt ED, French AJ, Lopez D, Polo SHL, Boyko V, Dinh MT, Rask JC, Chakravarty K, Stewart H, Del Alto ME. Temporal RNA Integrity Analysis of Archived Spaceflight Biological Samples. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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22
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Tiegs AW, Sun L, Patounakis G, Scott RT. Erratum. Worth the wait? Day 7 blastocysts have lower euploidy rates but similar sustained implantation rates as Day 5 and Day 6 blastocysts. Hum Reprod 2019; 34:2559-2560. [PMID: 31769486 DOI: 10.1093/humrep/dez219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/02/2019] [Accepted: 09/11/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- A W Tiegs
- Instituto Valenciano de Infertilidad - Reproductive Medicine Associates (IVI-RMA), Basking Ridge, NJ 07920, USA.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - L Sun
- Foundation for Embryonic Competence (FEC), Basking Ridge, NJ 07920, USA
| | - G Patounakis
- Reproductive Medicine Associates of Florida, Orlando, FL 32746, USA
| | - R T Scott
- Instituto Valenciano de Infertilidad - Reproductive Medicine Associates (IVI-RMA), Basking Ridge, NJ 07920, USA.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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23
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Neal SA, Sun L, Jalas C, Morin SJ, Molinaro TA, Scott RT. When next-generation sequencing-based preimplantation genetic testing for aneuploidy (PGT-A) yields an inconclusive report: diagnostic results and clinical outcomes after re biopsy. J Assist Reprod Genet 2019; 36:2103-2109. [PMID: 31471748 DOI: 10.1007/s10815-019-01550-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/26/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To describe diagnostic results following re-biopsy of blastocysts with inconclusive results on preimplantation genetic screening for aneuploidy (PGT-A) and to evaluate the reproductive potential of re-biopsied blastocysts. METHODS This retrospective cohort study included all trophectoderm biopsies submitted for PGT-A by a large in vitro fertilization center to a single genetics laboratory from June 2016 to October 2018. PGT-A was performed using next-generation sequencing (NGS). No-result blastocysts that underwent re-biopsy were subsequently classified as euploid, aneuploid, mosaic/segmental, or no-result. Ongoing pregnancy and clinical loss rates were assessed following transfer of re-biopsied blastocysts. Logistic regressions were conducted to account for age and blastocyst morphology. RESULTS Of the trophectoderm biopsies submitted for PGT-A, 635/25,199 (2.5%) were categorized as no-result. Those that underwent re-biopsy (n = 250) had a 95.2% diagnostic rate with 140 (56.0%) receiving euploid diagnoses. Thirty-six re-biopsied blastocysts deemed euploid were subsequently transferred, resulting in 18 (50.0%) ongoing pregnancies and 5 (13.9%) clinical losses. After adjusting for age and blastocyst morphology, there remained a lower ongoing pregnancy rate and a trend towards higher clinical loss rate following transfer of a re-biopsied blastocyst. When compared to blastocysts that underwent the same number of vitrification-warming cycles but only one biopsy, there were no differences in outcomes. CONCLUSIONS Failure to obtain an analytical result does not change the probability that a given blastocyst is euploid. Pregnancy outcomes following transfer of re-biopsied blastocysts are favorable, but further data must be accrued for an adequately powered comparison with outcomes after transfer of blastocysts biopsied once.
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Affiliation(s)
- Shelby A Neal
- IVI/RMA New Jersey, 140 Allen Rd, Basking Ridge, NJ, 07920, USA. .,Foundation for Embryonic Competence, 140 Allen Rd, Basking Ridge, NJ, 07920, USA.
| | - L Sun
- Foundation for Embryonic Competence, 140 Allen Rd, Basking Ridge, NJ, 07920, USA
| | - C Jalas
- Foundation for Embryonic Competence, 140 Allen Rd, Basking Ridge, NJ, 07920, USA
| | - S J Morin
- IVI/RMA New Jersey, 140 Allen Rd, Basking Ridge, NJ, 07920, USA.,Sidney Kimmel College of Medicine, Thomas Jefferson University, 1025 Walnut St., #100, Philadelphia, PA, 19107, USA
| | - T A Molinaro
- IVI/RMA New Jersey, 140 Allen Rd, Basking Ridge, NJ, 07920, USA
| | - R T Scott
- IVI/RMA New Jersey, 140 Allen Rd, Basking Ridge, NJ, 07920, USA
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24
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Tiegs AW, Sun L, Patounakis G, Scott RT. Worth the wait? Day 7 blastocysts have lower euploidy rates but similar sustained implantation rates as Day 5 and Day 6 blastocysts. Hum Reprod 2019; 34:1632-1639. [DOI: 10.1093/humrep/dez138] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/11/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
STUDY QUESTION
Does the reproductive potential of embryos change when blastocyst development takes longer than the traditionally accepted 5 days when accounting for aneuploidy and endometrial-embryo asynchrony?
SUMMARY ANSWER
Aneuploidy increases with increasing duration of blastulation, but if blastocyst morphologic quality and endometrial-embryo asynchrony are controlled for, euploid Day 7 embryos have similar sustained implantation as compared to Days 5 and 6 euploid blastocysts.
WHAT IS KNOWN ALREADY
The relative contributions of diminished embryo quality versus endometrial and embryo asynchrony to poor outcomes associated with embryos cultured past Day 6 are not clear. Asynchrony can be eliminated by embryo vitrification with transfer in a subsequent month after retrieval.
STUDY DESIGN, SIZE, DURATION
Retrospective cohort study of patients from a single center attempting conception through ICSI and utilizing preimplantation genetic testing for aneuploidy screening (PGT-A) from January 2017 to September 2018. Cycles were excluded if they utilized surgical sperm or preimplantation genetic testing for monogenetic/single gene defects. ICSI cycle outcomes from 2586 patients were evaluated for ploidy status of embryos.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Only patients undergoing single, euploid frozen embryo transfer were included when analyzing cycle outcomes by day of blastocyst expansion of the transferred embryo (n = 2130). Ploidy rates by the day upon which an embryo was considered to be usable (denoted, ‘usable blastulation day’) were determined so as to assess the contribution of aneuploidy to slow embryo development. Outcomes of euploid frozen single embryo transfers (SET) of Day 7 embryos were evaluated to assess the reproductive potential associated with embryos that were slowly developing for reasons other than aneuploidy. Analyses were adjusted by maternal age and blastocyst morphology.
MAIN RESULTS AND THE ROLE OF CHANCE
Overall, 67.7% (n = 3508) of usable Day 5 blastocysts were euploid, 52.1% (n = 5560) of usable Day 6 blastocysts were euploid and 43.1% (n = 229) of usable Day 7 embryos were euploid (Day 5 versus Day 6: odds ratio (OR) 0.7 (95% CI, 0.64–0.76), P < 0.001; Day 5 versus Day 7: OR 0.56 (95% CI, 0.46–0.69), P < 0.001; Day 6 versus Day 7: OR 0.81 (95% CI, 0.67–0.99), P = 0.036). Stratified by Society for Assisted Reproductive Technology maternal age groups, a reduction in the prevalence of euploidy by increasing time to embryo blastulation was still seen. The sustained implantation rate (SIR) was similar after euploid SET of Days 5 and 6 embryos (overall, 68.9% (95% CI, 66.0–71.6) and 66.8% (95% CI, 63.8–69.7), respectively; P = 0.81). SIR after euploid Day 7 SET appeared slightly lower than that of Days 5 and 6 embryos (52.6% (95% CI, 35.8–69.0); (Day 5 versus Day 7: OR, 0.67 (95% CI, 0.32–1.41), P = 0.29; Day 6 versus Day 7: OR 0.58 (95% CI, 0.28–1.2), P = 0.14)) but did not achieve statistical significance.
LIMITATIONS, REASONS FOR CAUTION
The primary limitation is the low number of Day 7 blastocyst transfers that limits statistical power. Additionally, the retrospective nature of this study may prevent full elucidation of potential biases with respect to culture, morphologic assessment and selection of Day 7 embryos for transfer.
WIDER IMPLICATIONS OF THE FINDINGS
Routine culture through Day 7 may successfully increase the pool of transferrable embryos for patients who would otherwise have no usable embryos if culture terminated on Day 6. This is particularly true for older patients (i.e. greater than 35 years of age), whose embryos take longer to blastulate and, therefore, are more susceptible to cycle cancelation. Additionally, as evidenced by an adequate overall SIR of 52.6% after euploid SET of Day 7 blastocysts, embryos developing to a usable blastocyst on Day 7 are likely within the ‘window of blastulation.’
STUDY FUNDING/COMPETING INTEREST(S)
None.
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Affiliation(s)
- A W Tiegs
- Instituto Valenciano de Infertilidad - Reproductive Medicine Associates (IVI-RMA), Basking Ridge, NJ, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - L Sun
- Foundation for Embryonic Competence (FEC), Basking Ridge, NJ, USA
| | - G Patounakis
- Reproductive Medicine Associates of Florida, Orlando, FL 32746, USA
| | - R T Scott
- Instituto Valenciano de Infertilidad - Reproductive Medicine Associates (IVI-RMA), Basking Ridge, NJ, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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25
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Rudolph J, Scott RT, Galli M, Brigido SA, Cooper MT. All Things Syndesmosis. Foot Ankle Spec 2019; 12:370-372. [PMID: 31526088 DOI: 10.1177/1938640019875563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Arthrodesis of the ankle or foot is a common procedure for chronic pain and disability. Nonunion remains a prevalent complication among arthrodesis procedures. Some patients present with an inherent risk of developing a nonunion. Allograft biologics have gained popularity in an effort to reduce complications such as nonunion. Various biologics bring unique properties while maintaining a singular purpose. Platelet-derived growth factor (PDGF) may be introduced into a fusion site to facilitate healthy bony consolidation. The purpose of this article is to review the benefits and modalities of PDGF and how it can improve patient outcomes in ankle and hindfoot fusions.
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Affiliation(s)
- Ryan T Scott
- The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA.
| | - Jeffrey E McAlister
- The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023, USA
| | - Ryan B Rigby
- Logan Regional Orthopedics, 1350 North 500 East, Logan, UT 84341, USA
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27
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Zimmerman RS, Tao X, Marin D, Werner MD, Hong KH, Lonczak A, Landis J, Taylor D, Zhan Y, Scott RT, Treff NR. Preclinical validation of a targeted next generation sequencing-based comprehensive chromosome screening methodology in human blastocysts. ACTA ACUST UNITED AC 2017; 24:37-45. [DOI: 10.1093/molehr/gax060] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022]
Affiliation(s)
- R S Zimmerman
- Foundation for Embryonic Competence, 140 Allen Road, Suite 300, Basking Ridge, NJ, USA
| | - X Tao
- Foundation for Embryonic Competence, 140 Allen Road, Suite 300, Basking Ridge, NJ, USA
| | - D Marin
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, USA
| | - M D Werner
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, USA
| | - K H Hong
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, USA
| | - A Lonczak
- Foundation for Embryonic Competence, 140 Allen Road, Suite 300, Basking Ridge, NJ, USA
| | - J Landis
- Foundation for Embryonic Competence, 140 Allen Road, Suite 300, Basking Ridge, NJ, USA
| | - D Taylor
- Foundation for Embryonic Competence, 140 Allen Road, Suite 300, Basking Ridge, NJ, USA
| | - Y Zhan
- Foundation for Embryonic Competence, 140 Allen Road, Suite 300, Basking Ridge, NJ, USA
| | - R T Scott
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, USA
| | - N R Treff
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, USA
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Prissel MA, Berlet GC, Scott RT, Daigre JL, Bull PE, Peterson KS, Collins CL, Hyer CF. Radiographic Assessment of a Medullary Total Ankle Prosthesis: A Test of Agreement and Reliability. Foot Ankle Spec 2016; 9:486-493. [PMID: 27412962 DOI: 10.1177/1938640016656785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Total ankle replacement (TAR) is a viable alternative to ankle fusion in certain patients with end-stage ankle arthritis. Despite the importance of understanding alignment and movement of the prosthesis, there is no standardized radiographic method for evaluating the position and movement of the INBONE 2 prosthesis. The aims of this study were to describe a radiographic measurement protocol for INBONE 2 for clinical practice and research while determining the interobserver and intraobserver reliability using standard weightbearing radiographs. Fifteen patients were randomly selected with operative dates from January 2011 to January 2014 who underwent primary TAR using the INBONE 2 prosthesis. Most recent preoperative and first postoperative weightbearing anteroposterior and lateral radiographs were pulled and deidentified. Three foot and ankle surgeons blinded from the patient selection and deidentification, measured the described measurements on separate occasions. Intraobserver reliability: surgeon 1 had acceptable reliability for 9 of 13 continuous radiographic measurements (69.2%), surgeon 2 had acceptable reliability for 8 of 13 measurements (61.5%), and surgeon 3 had acceptable reliability for 12 of 13 measurements (92.3%). Interobserver reliability: among the first measurements, 6 of 13 continuous radiographic measurements (46.2%) had acceptable reliability. Among the second measurements, 7 of 13 measurements (53.8%) had acceptable reliability. Among the first and second measurements combined, 7 of 13 measurements (53.8%) had acceptable reliability. This study promotes the need for meticulous evaluation of annual radiographic findings following TAR in an effort to avoid catastrophic failure and represents moderate agreement can be obtained by employing the proposed measurements for surveillance of INBONE 2 TAR at annual postoperative visits. Measurements on the anteroposterior radiograph appear to demonstrate more consistent results for surveillance than lateral measurements. The intraobserver reliability results were somewhat superior to the interobserver reliability, implying more relevance for a single surgeon applying these measurements annually for postoperative surveillance. LEVELS OF EVIDENCE Diagnostic, Level III.
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Affiliation(s)
- Mark A Prissel
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Gregory C Berlet
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Ryan T Scott
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Justin L Daigre
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Patrick E Bull
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Kyle S Peterson
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Christy L Collins
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
| | - Christopher F Hyer
- Atlantic Foot & Ankle Center, Chesapeake, Virginia (MAP).,Orthopedic Foot & Ankle Center, Westerville, Ohio (PEB, GCB, CFH).,The CORE Institute, Phoenix, AZ (RTS).,Decatur Orthopaedic Clinic, Decatur, Alabama (JLD).,Suburban Orthopaedics, Bartlett, IL (KSP).,OhioHealth Research and Innovation Institute, Columbus, Ohio (CLC)
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Abstract
Category: Basic Sciences/Biologics Introduction/Purpose: Plantar Fasciitis is the most common cause of heel pain in adults, and is estimated to affect nearly 1 million patients annually. Conservative treatments include rest, orthotics, night splint, stretching and non-steroidal anti- inflammatory drugs and are successful in nearly 90% of patients. However, more invasive treatments are required for patients whose symptoms persist greater than six months. Fetal tissues, including the umbilical cord (UC) and amniotic membrane (AM) have been increasingly used to modulate healing in different parts of the body over the last two decades. These tissues have been demonstrated to possess anti-inflammatory and anti-scarring properties in addition to containing growth factors, cytokines, and matrix components to promote healing, and offer a potential therapy for plantar fasciitis. Methods: In this series, we aim to evaluate the efficacy of cryopreserved, particulate UC/AM tissues as a treatment for plantar fasciitis as well as to determine if multiple injections provide an even greater benefit compared to a single injection. A multicenter prospective study was performed where patients were randomized to receive 25, 50, or 100 mg UC/AM tissue and either a single injection or two injections (at baseline and six weeks). All injections were administered under ultrasound guidance into the plantar fascia. At six, 12, and 18 weeks, patients returned and data on foot pain as well as the FAAM questionnaire were collected. Results: Interim six-week data for 18 patients has been collected. Patient foot pain was found to be reduced by approximately 50% from baseline (7.1 to 3.5 on a 10 point scale). FAAM scores also improved significantly. All patients showed variable degrees of improvement with no patients showing any deterioration. Conclusion: Hanselman et al evaluated the safety and efficacy of cryopreserved, particulate human amniotic membrane (cHAM) injections against a corticosteroid. They found cHAM injections safe and comparable to corticosteroids. In addition, the outcomes suggested a possible additive effect, with multiple injections of cHAM tissue showing a greater improvement in foot pain. The finding of our study are similar to the average verbal percentage improvement compared to baseline reported by Hanselman et al for the cHAM study group (46% improvement at six weeks). Overall, a total of 60 subjects will be enrolled in the present study.
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Franasiak JM, Wang X, Molinaro TA, Green K, Sun W, Werner MD, Juneau CR, Scott RT. Free vitamin D does not vary through the follicular phase of the menstrual cycle. Endocrine 2016; 53:322-6. [PMID: 27052515 DOI: 10.1007/s12020-016-0946-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/28/2016] [Indexed: 12/11/2022]
Abstract
The importance of vitamin D (25OHD) in general health and reproductive success has been a focus in the setting of the 25OHD deficiency epidemic. However, there are challenges to understanding 25OHD's effects. The free and bioavailable levels are affected by 25OHD binding protein (DBP) and it is not known how estradiol fluctuations during the menstrual cycle affect these binding parameters. This may impact the most appropriate time to measure 25OHD when determining deficiency. This study characterizes 25OHD throughout the follicular phase of the menstrual cycle. Patients undergoing natural cycle IVF were included. Serum was drawn throughout the follicular phase of the menstrual cycle; 25OHD, DBP, albumin, and estrogen levels were determined for each time point allowing for mathematical calculation of free and bioavailable 25OHD. Early, mid, and late follicular phases were designated by estrogen tertiles among patients. Mean Levels of 25OHD (total, free, bioavailable) and DBP for each tertile were compared with Kruskil-Wallis test for non-parametric groups. Linear regression with GEE was employed due to repeated measures within participants. A total of 33 patients were included with 202 total serum measurements. There was no difference in mean levels of 25OHD (p = 0.77), free 25OHD (p = 0.91), and bioavailable 25OHD (p = 0.76) when measured throughout the follicular phase of the menstrual cycle. Vitamin D metabolism does not fluctuate as estradiol changes in the follicular phase of the menstrual cycle. This data indicates that assessment of 25OHD, in particular when assessed for associations with reproductive outcomes, can be measured reliably at any point during the follicular phase of the menstrual cycle.
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Affiliation(s)
- J M Franasiak
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA.
| | - X Wang
- Division of Endocrinology, Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - T A Molinaro
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - K Green
- Division of Reproductive Endocrinology, National Institute of Health and Human Services, Bethesda, MD, USA
| | - W Sun
- Division of Endocrinology, Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - M D Werner
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - C R Juneau
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - R T Scott
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
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Franasiak JM, Werner MD, Juneau CR, Tao X, Landis J, Zhan Y, Treff NR, Scott RT. Endometrial microbiome at the time of embryo transfer: next-generation sequencing of the 16S ribosomal subunit. J Assist Reprod Genet 2016; 33:129-36. [PMID: 26547201 PMCID: PMC4717132 DOI: 10.1007/s10815-015-0614-z] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/29/2015] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Characterization of the human microbiome has become more precise with the application of powerful molecular tools utilizing the unique 16S ribosomal subunit's hypervariable regions to greatly increase sensitivity. The microbiome of the lower genital tract can prognosticate obstetrical outcome while the upper reproductive tract remains poorly characterized. Here, the endometrial microbiome at the time of single embryo transfer (SET) is characterized by reproductive outcome. METHODS Consecutive patients undergoing euploid, SET was included in the analysis. After embryo transfer, performed as per routine, the most distal 5-mm portion of the transfer catheter was sterilely placed in a DNA free PCR tube. Next-generation sequencing of the bacteria specific 16S ribosome gene was performed, allowing genus and species calls for microorganisms. RESULTS Taxonomy assignments were made on 35 samples from 33 patients and 2 Escherichia coli controls. Of the 33 patients, 18 had ongoing pregnancies and 15 did not. There were a total of 278 different genus calls present across patient samples. The microbiome at time of transfer for those patients with ongoing pregnancy vs. those without ongoing pregnancy was characterized by top genera by sum fraction. Lactobacillus was the top species call for both outcomes. CONCLUSIONS The data presented here show the microbiome at the time of embryo transfer can successfully be characterized without altering standard clinical practice. This novel approach, both in specimen collection and analysis, is the first step toward the goal of determining physiologic from pathophysiologic microbiota. Further studies will help delineate if differences in the microbiome at the time of embryo transfer have a reliable impact on pregnancy outcome.
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Affiliation(s)
- J M Franasiak
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA.
| | - M D Werner
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - C R Juneau
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - X Tao
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - J Landis
- Foundation for Embryonic Competence, Basking Ridge, NJ, USA
| | - Y Zhan
- Foundation for Embryonic Competence, Basking Ridge, NJ, USA
| | - N R Treff
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
| | - R T Scott
- Division of Reproductive Endocrinology, Department of Obstetrics Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
- Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07920, USA
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Abstract
Patients with diabetic neuropathy that develop unstable Charcot neuroarthropathy not only have an autoimmune disease that prolongs the healing process, they also often have an inability to maintain a non-weight bearing status. Charcot neuroarthopathy is often devastating to the structure and stability of the foot and ankle. This disease may require permanent bracing, reconstructive surgical stabilization, and in some cases lower leg amputation. Successful management of Charcot neuroarthopathy requires diligence and surveillance by physician and patient alike.
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Affiliation(s)
- Ryan T Scott
- Department of Orthopedics, The CORE Institute, 18444 N 25th Avenue, Unit 320, Phoenix, AZ 85023, USA.
| | | | - Christopher F Hyer
- Orthopedic Foot and Ankle Center, Westerville Medical Campus, 300 Polaris Parkway, Suite 2000, Westerville, OH 43082, USA
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Abstract
Supramalleolar osteotomies are powerful osteotomies that realign the tibiotalar and optimize hindfoot position in the presence of varus, valgus, procurvatum, recurvatum, as well as internal and external rotation of the tibia. Although used in the pediatric and hemophilic population earlier, supramalleolar osteotomy is a relatively new reconstructive surgical technique that was introduced in 1995. Conducted primarily in cancellous bone, supramalleolar osteotomies offer rapid, reliable bony consolidation compared with dome osteotomies and complex arthrodesis.
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Affiliation(s)
- Melissa M Galli
- Department of Orthopedics, The CORE Institute, 18444 North 25th Avenue, Suite 210, Phoenix, AZ 85023-1264, USA
| | - Ryan T Scott
- Department of Orthopedics, The CORE Institute, 18444 North 25th Avenue, Suite 320, Phoenix, AZ 85023, USA.
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Abstract
The fifth metatarsal Jones fracture is a well-documented injury occurring at the proximal diaphyseal-metaphyseal junction. Conservative versus surgical intervention has been discussed in published studies for the management of Jones fractures. Solid intramedullary fixation relies on accurate matching of the screw diameter to the intraosseous diameter. The purpose of the present cadaveric study was to determine the average intraosseous diameter of the proximal fifth metatarsal as it relates to screw size selection for Jones fracture stabilization. Twenty fresh-frozen cadaver legs were used for examination. The fifth metatarsal was completely dissected. A transverse osteotomy was performed from laterally to medially along the midline of the metatarsal. A digital caliper was used to measure the diameter of the medullary canal of the fifth metatarsal. The measurement was taken at the narrowest portion of the medullary canal just distal to the proximal metaphysis. The mean dorsal to plantar diameter of the fifth metatarsal was 6.475 ± 1.54 (range 4 to 12) mm and the mean medial to lateral diameter was 4.6 ± 0.85 (range 3 to 6) mm. Intramedullary screw fixation has shown beneficial results in the treatment protocol of fifth metatarsal Jones fractures. Our study has demonstrated that a 4.5-mm cannulated screw is the narrowest diameter screw that can be used in the average fifth metatarsal and still obtain adequate intraosseous purchase. When selecting the appropriate screw, the surgeon must be comfortable selecting the largest screw that will achieve the maximal interface with the dense cortical bone in both the medial to lateral and dorsal to plantar plane.
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Affiliation(s)
- Ryan T Scott
- Podiatric Surgeon, The CORE Institute, Phoenix, AZ
| | - Christopher F Hyer
- Fellowship Director, Advanced Foot and Ankle Surgical Fellowship, Orthopedic Foot and Ankle Center, Westerville, OH.
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Berlet GC, Hyer CF, Scott RT, Galli MM. Medial double arthrodesis with lateral column sparing and arthrodiastasis: a radiographic and medical record review. J Foot Ankle Surg 2014; 54:441-4. [PMID: 25488190 DOI: 10.1053/j.jfas.2014.10.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Indexed: 02/03/2023]
Abstract
Correction of valgus hindfoot deformity can be successfully achieved with arthrodesis of the subtalar and talonavicular joints through a single medial based incision. The advantages of medial double arthrodesis compared with the standard triple arthrodesis 2-incision approach include the absence of a lateral incision and a few degrees of residual mobility through the unfused calcaneocuboid joint (CCJ). The CCJ has often been noted to distract and decompress with the abduction correction achieved through medial double fusion. The primary goal of the present retrospective study was to identify the frequency of CCJ decompression, measure the radiographic changes at the CCJ, and evaluate the flatfoot correction using this operative approach. A total of 46 patients (47 feet) were identified as possible subjects. Twenty patients (20 feet) with a mean follow-up period of 9.2 ± 4.1 (range 6 to 21) months met our inclusion criteria. Distraction of the CCJ using medial double fusion resulted in increased joint space and improvement of at least 1 grade of arthritis in 50% of the patients. In the patients with severe CCJ arthrosis, the improvement was less predictable, with only 20% showing radiographic improvement. Correction of flatfoot as measured on standard radiographs showed excellent results. Subchondral bone changes as measured by the CCJ arthrosis scale improved in patients with mild to moderate arthritis after distraction arthrodiastasis. However, those with severe preoperative CCJ had less predictable improvement. Medial double arthrodesis for severe flatfoot deformity provides predictable correction of the deformity and improvement in the CCJ arthritis scale when the preoperative arthritis of the CCJ is mild to moderate.
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Affiliation(s)
- Gregory C Berlet
- Fellowship Director for Advanced Orthopedic Foot and Ankle Fellowship, Orthopedic Foot and Ankle Center, Westerville, OH
| | - Christopher F Hyer
- Fellowship Director for Advanced Foot and Ankle Surgical Fellowship, Orthopedic Foot and Ankle Center, Westerville, OH.
| | - Ryan T Scott
- Attending Physician, The CORE Institute, Phoenix, AZ
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Abstract
Although discussed as an alternative to triple arthrodesis for hindfoot correction, the published data surrounding the medial double arthrodesis, or fusion of the subtalar and talonavicular joints, has not addressed the proximity of the anatomic structures at risk. A total of 10 cadaver specimens were used to examine the risk of damage to the neurovascular and tendinous structures of the posterior medial hindfoot when performing the medial double arthrodesis. The distance of the reviewed structures was measured in relation to the standardized point of the middle facet of the calcaneus (mean ± standard deviation and range). The proximity of the middle facet to the posterior tibial tendon was 1.88 ± 2.65 (range 0 to 6.65) mm, to the flexor digitorum longus tendon was 5.34 ± 4.79 (range -3.14 to 12.79) mm, to the flexor hallucis longus tendon was 19.08 ± 4.84 (range 13.04 to 27.31) mm, and to the neurovascular bundle was 21.19 ± 7.84 (range 8.36 to 34.26) mm. At the level of the middle facet, the posterior tibial tendon was the largest tendon, measuring 7.14 ± 2.21 (range 3.31 to 10.23) mm by 2.95 ± 0.88 mm (range 1.86 to 4.24 mm; area 22.37 ± 12.23 mm(2), range 6.16 to 43.38 mm) followed by the flexor digitorum longus tendon at 4.25 ± 1.25 (range 1.74 to 5.95) mm by 2.25 ± 0.96 mm (range 1.41 to 4.79 mm; area 8.88 ± 2.62 mm(2), range 6.12 to 14.52 mm) and flexor hallucis longus tendon at 5.75 ± 2.05 (range 2.27 to 8.91) mm by 2.75 ± 0.82 mm (range 1.35 to 4.13 mm; area 16.81 ± 10.05 mm(2), range 4.81 to 36.80 mm). During dissection for the medial double arthrodesis, one can encounter critical anatomic structures, including artery, vein, nerve, and tendon. Our cadaveric investigation found a mean safe distance of more than 2 cm between the middle facet of the talocalcaneal articulation and the inferiorly located neurovascular bundle using the medial double arthrodesis approach.
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Affiliation(s)
- Melissa M Galli
- Resident, Ohio State University Medical Center. Columbus, OH
| | - Ryan T Scott
- Fellow, Orthopedic Foot and Ankle Center. Westerville, OH
| | | | - Safet Hatic
- Fellow, Orthopedic Foot and Ankle Center. Westerville, OH
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Abstract
While the medial double arthrodesis has gained significant popularity for hindfoot arthrodesis in recent years, much has been touted about the efficiency and cost savings of the procedure in comparison to its triple counterpart without any literature to reinforce this claim. The purpose of this retrospective study was to compare the hardware costs and operative time between the medial double and triple arthrodeses. A total of 276 patients (277 feet) were identified via CPT codes with 47 hindfoot cases (47 feet) meeting the inclusion criteria consisting of 21 medial double (6 males, 15 females) and 26 triple (8 males, 18 females) arthrodeses. No significant difference was noted in age, body mass index, gender, chronic steroid use, preoperative osteopenia/osteoporosis, tobacco abuse, surgical side, presence of diabetes, immune compromised state, kidney disease, rheumatoid arthritis, or liver disease. Mean medial double operative (OR) time 106 ± 31 minutes (range = 73-201 minutes) with a procedure time of 84 ± 29 minutes (range = 44-163 minutes) was identified versus an OR time of 127 ± 23 minutes (range = 91-200 minutes) and procedure time of 104 ± 23 minutes (range = 50-169 minutes) for the triple arthrodesis group. The mean fixation cost for the triple arthrodesis was found to be higher with the mean triple hardware cost $2932.75 ± $736.60 (range = $1434.00 to $3980.00) against the medial double's $1197.59 ± $635.57 (range = $463.20 to $2019.00). Both efficiency and cost were found to favor the medial double for hindfoot arthrodesis at a level of statistical significance level (P = .0028 for OR time, P = .0033 for procedure time, and P < .0001 for cost).
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Affiliation(s)
- Melissa M Galli
- Department of Orthopaedics, The Ohio State University, Columbus, Ohio (MMG)
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Abstract
UNLABELLED With this study we intend to determine if there is a correlation between body mass index (BMI) and Achilles tendon pathology. A retrospective chart review of 197 patients was performed with CPT codes of Achilles tendinosis/tendonitis. These 197 patients were then compared with 100 random new patient encounters excluding Achilles pathology, plantar fasciitis, and surgical consults. Statistical analysis was then performed to identify correlation of BMI to incidence of Achilles tendinosis compared with patients without Achilles pathology. A total of 197 Achilles tendon pathology patients (113 male, 84 female) were analyzed and had a mean age of 52.77 ± 11.8 years (21-82) with a BMI of 34.69 ± 7.54 (17.9-75.9). The control group had a mean age of 42.74 ± 12.1 years (21-78) and mean BMI of 30.56 ± 7.55 (19.7-61.5). A significant difference was found in mean BMI between the Achilles tendinopathy group versus the control group (P < .001). There was a very significant difference in age noted between the 2 cohorts (52.77 years vs 42.74 years, P < .001), perhaps reenforcing the involvement of age-related degenerative changes. In this study, patients with Achilles pathology exhibited a significantly higher BMI than non-Achilles patients (P < .001) even after accounting for age. LEVELS OF EVIDENCE Prognostic Level II.
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Affiliation(s)
- Ryan T Scott
- Orthopedic Foot and Ankle Center, Westerville, Ohio 43802, USA
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Hyer CF, Galli MM, Scott RT, Bussewitz B, Berlet GC. Ankle valgus after hindfoot arthrodesis: a radiographic and chart comparison of the medial double and triple arthrodeses. J Foot Ankle Surg 2013; 53:55-8. [PMID: 23910739 DOI: 10.1053/j.jfas.2013.02.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Indexed: 02/03/2023]
Abstract
The medial double arthrodesis, comprised of subtalar and talonavicular joint fusions, has become a popular way to correct hindfoot deformity. There is potential concern for an increase in ankle valgus postoperatively owing to extended medial dissection and possible disruption of the deltoid ligament. Although this approach is often used to correct a valgus hindfoot, little attention has been paid to date on this procedure's effect on the tibiotalar joint. Although the medial double arthrodesis has been shown to produce reproducible outcomes without violating the lateral hindfoot structures, our hypothesis was that this approach would increase the ankle valgus deformity compared with its triple counterpart. The primary goal of the present retrospective study was to identify the frequency and severity of ankle valgus after the medial double arthrodesis compared with the triple arthrodesis. A total of 77 patients (78 feet) met our inclusion criteria. Their mean age was 61.3 ± 10.7 (range 27 to 79) years, and the follow-up period was 15.7 ± 9.9 (range 6 to 46) months. There were 16 and 61 patients (62 feet) in the medial double and triple arthrodesis groups, respectively. Overall, the preoperative ankle valgus was 1.24° ± 2.02° (range 0° to 6°), and there was no statistical difference of preoperative ankle valgus noted between groups (p = .060). Collectively, postoperative ankle valgus was 3.01° ± 3.54° (0° to 17°) with an increase in ankle valgus in 4 of 16 medial double and 34 of 62 triple arthrodesis patients. With a mean follow-up of 8.75 ± 4.02 (6 to 21) months, the medial double arthrodesis cohort's ankle valgus increased from 0.5° ± 1.55° (0° to 6°) to 1.5° ± 3.14° (1° to 10°) postoperatively. The triple arthrodesis group had a mean follow-up 17.53 ± 10.17 (6 to 46) months and ankle valgus increased from 1.44° ± 2.09° (0 to 6°) to 3.40° ± 3.56° (0° to 17°). Postoperative ankle valgus was statistically significant between groups (U = 303.50, p = .013). The odds of having an increase in the valgus ankle angle for patients in the triple group was 3.64 times that for patients in the double group, while holding all other variables in the model constant.
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Affiliation(s)
| | - Melissa M Galli
- Resident, Ohio State University Medical Center, Columbus, OH
| | - Ryan T Scott
- Fellow, Orthopedic Foot and Ankle Center, Westerville, OH
| | | | - Gregory C Berlet
- Attending Physician, Orthopedic Foot and Ankle Center, Westerville, OH
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40
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Abstract
Hammertoe digital deformity correction is a very controversial topic among foot and ankle surgeons. Hammertoes are characterized by an extension deformity at the metatarsophalangeal joint (MTPJ) and flexion deformity at the proximal interphalangeal joint (PIPJ). Current treatment options are often guided by the patient's discomfort as well as the reducibility of the affected digit. Kirschner wires (K-wires) have long been considered the gold standard for hammertoe digital repair. Although K-wires are simplistic to use as fixation, they carry inherit risks such as pin tract infections, migration, and breakage. This has lead to multiple intramedullary hammertoe devices including the PROTOE intramedullary device. This paper will discuss the usage and benefits the PROTOE has to offer over the conventional K - wire.
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Abstract
UNLABELLED Degenerative joint disease of the ankle is a debilitating etiology, in which treatment has been disputed in the literature among healthy active patients. Total ankle arthroplasty had recently gained popularity as long-term outcomes are being reported and advancement in the design of the implants themselves evolves. Multiple implants are available on today's market including the INBONE (Wright Medical technologies, Arlington, TN) Total Ankle System. The second generation INBONE total ankle arthroplasty was launched and approved for use in the United States by the FDA in 2005. The second generation INBONE implant has a talar sulcus, allowing for a more biomechanically stable articulation between the polyethelene insert and the talar component (Figure 1). The initial INBONE implant had a flat articulation with the poly leading to instability. This paper will help to demonstrate the advantages of INBONE II versus INBONE I Total Ankle System in management of arthrosis of the ankle joint. LEVEL OF EVIDENCE Level V: Expert opinion.
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Affiliation(s)
- Ryan T Scott
- Orthopedic Foot and Ankle Center, Westerville, Ohio, USA
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Abstract
The lateral column lengthening procedure has been used in the surgical management of congenital and adult-acquired pes planus. Lateral column lengthening allows correction of the abducted forefoot and subsequent improvement in the medial longitudinal arch. However, owing to the inconsistent healing times and complications, we opted to pursue a novel approach to the lateral column lengthening procedure, the calcaneal Z osteotomy.
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Affiliation(s)
- Ryan T Scott
- Orthopedic Foot and Ankle Center, Westerville, OH, USA
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DeVries JG, Scott RT, Berlet GC, Hyer CF, Lee TH, DeOrio JK. Agility to INBONE: anterior and posterior approaches to the difficult revision total ankle replacement. Clin Podiatr Med Surg 2013; 30:81-96. [PMID: 23164441 DOI: 10.1016/j.cpm.2012.08.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Total ankle replacement is now acknowledged as a viable alternative to ankle arthrodesis for end-stage ankle arthritis. The authors present a series of 14 patients who were converted from the Agility total ankle replacement to an INBONE total ankle replacement. This report is unique in that anterior and posterior approaches are discussed and detailed. Although the authors present successful conversion of the Agility total ankle replacement to an INBONE total ankle replacement, the difficulty of this procedure is demonstrated by the high complication rate and 2 early failures.
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Affiliation(s)
- J George DeVries
- Excel Orthopedics, 705 South University Avenue, Suite 150, Beaver Dam, WI 53916, USA
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44
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Bussewitz BW, Scott RT, Hyer CF, Philbin TM. Strength evaluation of lateral calcaneal wall with circular external fixation application in cadaveric specimens. J Foot Ankle Surg 2012; 52:203-6. [PMID: 23253879 DOI: 10.1053/j.jfas.2012.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Indexed: 02/03/2023]
Abstract
Circular external fixation is a useful treatment option for the correction of complex trauma, extremity deformity, osteomyelitis, and reconstruction of the foot and ankle. The goal of the present study was to determine the degrees of bolt rotation required to create enough wire tension to cause structural failure of the lateral calcaneal wall when stressed with both olive and smooth wires in a cadaveric model. Ten fresh, thawed, below-the-knee specimens were tested at the San Diego Cadaveric Academic Research Symposium. The mean bolt rotation required to pull an olive wire through the lateral wall of the calcaneus was 79.8° ± 32.81°, and the mean bolt rotation required to "walk" a skinny wire (narrow diameter) and create 1 mm of cortical bone failure was 50.5° ± 30.91°. The results of the present investigation further define and elucidate the appropriate "Russian tensioning" technique applicable for external fixation of the calcaneus using olive or skinny wires in the case of fracture repair or compression arthrodesis.
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Forman EJ, Treff NR, Stevens JM, Garnsey HM, Katz-Jaffe MG, Scott RT, Schoolcraft WB. Embryos whose polar bodies contain isolated reciprocal chromosome aneuploidy are almost always euploid. Hum Reprod 2012; 28:502-8. [PMID: 23169867 PMCID: PMC3545638 DOI: 10.1093/humrep/des393] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
STUDY QUESTION When a chromosome aneuploidy is detected in the first polar body and a reciprocal loss or gain of the same chromosome is detected in the second polar body, is the resulting embryo usually aneuploid for that chromosome? SUMMARY ANSWER When reciprocal aneuploidy occurs in polar bodies, the resulting embryo is usually normal for that chromosome, indicating that premature separation of sister chromatids (PSSC)—not non-disjunction—likely occurred in meiosis I. WHAT IS KNOWN ALREADY Single-nucleotide polymorphism-based microarray analysis can be used to accurately determine the chromosomal status of polar bodies and embryos. Sometimes, the only abnormality found is a reciprocal gain or loss of one or two chromosomes in the two polar bodies. Prediction of the status of the resulting embryo in these cases is problematic. STUDY DESIGN, SIZE, DURATION Blinded microarray analysis of previously diagnosed aneuploid embryos that had reciprocal polar body aneuploidy. MATERIALS, SETTING, METHODS IVF cycles were performed between 2008 and 2011 in patients aged 40 ± 3 years (range 35–47 years) with an indication for polar body-based aneuploidy screening. Thirty-five aneuploid vitrified Day 3 embryos were warmed, cultured to Day 5 and biopsied for microarray analysis. Predictions were made for the ploidy status of the embryo if PSSC or non-disjunction had occurred. The signal intensity for the aneuploid chromosome in the first polar body was compared between those that resulted in euploid and aneuploid embryos. MAIN RESULTS AND THE ROLE OF CHANCE Among 34 embryos with evaluable results, 31 were euploid on re-analysis. Of 43 chromosomes that had reciprocal aneuploidy in the polar bodies, 41 were disomic in the embryo, indicating that PSSC was likely to have occurred 95% (95% confidence interval 85–99%) of the time. The log 2 ratio signal intensity from the chromosomes that underwent non-disjunction, resulting in unbalanced embryos, were outliers when compared with those that underwent PSSC. LIMITATIONS, REASONS FOR CAUTION Although most embryos with reciprocal aneuploid polar bodies were euploid, it is unknown whether they maintain equivalent reproductive potential when transferred. Further study is needed to determine whether these embryos should be re-biopsied and considered for transfer. WIDER IMPLICATIONS OF THE FINDINGS This study is consistent with increasing evidence that PSSC is the primary cause of meiosis I errors in embryos from women of advanced reproductive age. Clinicians should be cautious in interpreting results from polar body aneuploidy screening, especially when only the first polar body is tested. STUDY FUNDING/COMPETING INTEREST(S) None.
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Affiliation(s)
- E J Forman
- Reproductive Medicine Associates of New Jersey, Morristown, NJ 07960, USA.
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46
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Abstract
The use of cellular allograft containing mesenchymal stem cells is gaining popularity as an augmentation to foot and ankle arthrodesis. Those with underlying comorbidities (diabetes mellitus, Charcot osteoarthropathy, smoking, suppressive medication, increased body mass index) are more likely to require surgical revision procedures and typically have a greater rate of nonunion than their healthy counterparts. We believe that the use of a mesenchymal stem cell graft will increase the likelihood of a successful fusion during the primary procedure. The present study reviewed the use of stem cell grafting in hindfoot and ankle surgery and the healing times in high-risk patients. Successful fusion was defined as bridging across 3 cortices. In this patient group, the average interval to radiologic union was 11.1 ± 2.0 (range 8 to 15) weeks. The interval to partial weightbearing was 5.5 ± 1.8 (range 3 to 12) weeks, to full weightbearing was 8.4 ± 1.9 (range 5 to 14) weeks, and to shoe wearing was 13.6 ± 3.0 (range 10 to 20) weeks.
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Affiliation(s)
- Ryan T Scott
- Orthopedic Foot and Ankle Center, Westerville, OH 43082, USA
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47
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Hyer CF, Scott RT, Swiatek M. A retrospective comparison of first metatarsophalangeal joint arthrodesis using a locked plate and compression screw technique. Foot Ankle Spec 2012; 5:289-92. [PMID: 22935413 DOI: 10.1177/1938640012457936] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The historic primary treatment for end-stage first metatarsophalangeal (MTP) joint arthritis has been fusion. Traditionally, this has been accomplished by metaphyseal apposition between the proximal phalanx and metatarsal using crossed compression screws. Recently, locked plates have been introduced that help support this technique by offering added stability. We present our experience with 45 first MTP fusions in 45 feet using a locked plate and compression screw. METHODS A retrospective review of 45 patients who met the study criteria with a hallux rigidus correction using a locked plate with a compression screw was performed. Charts and radiographs were independently reviewed by 2 authors not involved in the index procedures to assess outcomes. RESULTS There was a 93% fusion rate (42/45 feet) with 3 nonunions. The mean time to union was 51.1 days (range = 29-116 days, SD = 24.4). The mean patient age was 58.1 years (range = 29-80 years, SD = 10.1). The mean time to partial weight bearing was 7.0 days (range = 0-53 days, SD = 13.8) and the mean time to full weight bearing was 62.0 days (range = 29-57 days, SD = 17.9). DISCUSSION We report on the results of first MTP fusion using a compression screw and locked plate technique. The results show that this is an effective means of creating a first MTP joint arthrodesis.
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Hyer CF, Scott RT, Swiatek M. A retrospective comparison of four plate constructs for first metatarsophalangeal joint fusion: static plate, static plate with lag screw, locked plate, and locked plate with lag screw. J Foot Ankle Surg 2012; 51:285-7. [PMID: 22459423 DOI: 10.1053/j.jfas.2012.02.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Indexed: 02/03/2023]
Abstract
The primary treatment for progressive first metatarsophalangeal (MTP) joint arthritis is arthrodesis. Multiple fixation types have been used to accomplish fusion including plating. There have been no published articles reporting the outcomes of these 4 plate and/or screw constructs. We present our experience with 138 first MTP joint fusions using these constructs. A retrospective comparison and radiographic chart review of 132 patients (138 feet) was performed to compare different constructs in regards to successful union and time to fusion. All operations were performed by 4 fellowship-trained foot and ankle surgeons. The radiographs were independently read by 2 authors not involved in the index procedures. Radiographic fusion was determined by bridging cortices across the joint line. The mean time to union (in days) and rate of fusion were static plate: 59, 95%, static plate with lag screw: 56, 86%, locked plate: 66, 92%, and locked plate with lag screw: 53, 96%. There was not a statistically significant difference between the groups in regards to patient age, time to weight bearing, time to fusion, or rate of fusion. We report on the results of fusion comparing 4 different plate and/or screw constructs for first MTP joint fusion. The data reveal no significant difference in time to fusion or rate of fusion between static and locked plates, with or without a lag screw.
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Forman EJ, Tao X, Ferry KM, Taylor D, Treff NR, Scott RT. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod 2012; 27:1217-22. [PMID: 22343551 PMCID: PMC3303493 DOI: 10.1093/humrep/des020] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Single embryo transfer (SET) provides the most certain means to reduce the risk of multiple gestation. Regrettably, prospective trials of SET have demonstrated reductions in per-cycle delivery rates. A validated method of comprehensive chromosome screening (CCS) has the potential to optimize SET by transferring only euploid embryos. This retrospective study evaluates the efficacy of SET with CCS in an infertile population. METHODS Overall and age-controlled ongoing pregnancy rates (OPR) were compared between women undergoing SET following CCS (CCS-SET, n= 140) and those undergoing SET without aneuploidy screening (control SET, n= 182). All transfers were at the blastocyst stage, with CCS performed after trophectoderm biopsy of expanded blastocysts and analysis with rapid PCR allowing for fresh transfer. RESULTS In the CCS-SET and control SET groups, an OPR of 55.0 and 41.8%, respectively, was obtained. The OPR was lower for the control group (P< 0.01) despite a younger age than the CCS group (37.3 ± 3.4 versus 34.2 ± 3.9 years; P< 0.001). Birthweight and gestational age at delivery were equivalent. The proportion of clinical pregnancies resulting in miscarriage was higher in the control group (24.8 versus 10.5%, P< 0.01), with more patients requiring surgical interventions for aneuploid pregnancies. There was one monozygotic twin delivery in the CCS group and none in the control group. CONCLUSIONS Compared with traditional blastocyst SET, SET after trophectoderm biopsy and rapid PCR-based CCS increases OPR and reduces the miscarriage rate. The enhanced selection empowered by CCS with SET may provide a practical way to eliminate multi-zygotic multiple gestation without compromising clinical outcomes per cycle.
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Affiliation(s)
- E J Forman
- Reproductive Medicine Associates of New Jersey, Morristown, NJ 07960, USA.
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Nguyen D, Alavi MV, Kim KY, Kang T, Scott RT, Noh YH, Lindsey JD, Wissinger B, Ellisman MH, Weinreb RN, Perkins GA, Ju WK. A new vicious cycle involving glutamate excitotoxicity, oxidative stress and mitochondrial dynamics. Cell Death Dis 2011; 2:e240. [PMID: 22158479 PMCID: PMC3252734 DOI: 10.1038/cddis.2011.117] [Citation(s) in RCA: 152] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Glutamate excitotoxicity leads to fragmented mitochondria in neurodegenerative diseases, mediated by nitric oxide and S-nitrosylation of dynamin-related protein 1, a mitochondrial outer membrane fission protein. Optic atrophy gene 1 (OPA1) is an inner membrane protein important for mitochondrial fusion. Autosomal dominant optic atrophy (ADOA), caused by mutations in OPA1, is a neurodegenerative disease affecting mainly retinal ganglion cells (RGCs). Here, we showed that OPA1 deficiency in an ADOA model influences N-methyl-D-aspartate (NMDA) receptor expression, which is involved in glutamate excitotoxicity and oxidative stress. Opa1(enu/+) mice show a slow progressive loss of RGCs, activation of astroglia and microglia, and pronounced mitochondrial fission in optic nerve heads as found by electron tomography. Expression of NMDA receptors (NR1, 2A, and 2B) in the retina of Opa1(enu/+) mice was significantly increased as determined by western blot and immunohistochemistry. Superoxide dismutase 2 (SOD2) expression was significantly decreased, the apoptotic pathway was activated as Bax was increased, and phosphorylated Bad and BcL-xL were decreased. Our results conclusively demonstrate that not only glutamate excitotoxicity and/or oxidative stress alters mitochondrial fission/fusion, but that an imbalance in mitochondrial fission/fusion in turn leads to NMDA receptor upregulation and oxidative stress. Therefore, we propose a new vicious cycle involved in neurodegeneration that includes glutamate excitotoxicity, oxidative stress, and mitochondrial dynamics.
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Affiliation(s)
- D Nguyen
- The Sophie and Arthur Brody Laboratory for Optic Nerve Biology, Hamilton Glaucoma Center, Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
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