Clinical Internal Dosimetry and Biodistribution of 177 Lu-DOTA-Trastuzumab in HER2-Positive Metastatic and Locally Advanced Breast Carcinoma.

OBJECTIVE: The aim of this study was to assess the biodistribution and dosimetry of 177 Lu-DOTA-trastuzumab in patients with HER2-positive breast carcinoma using whole-body (WB) planar imaging at multiple time points. PATIENTS AND METHODS: This study was a prospective evaluation of HER2-positive metastatic/locally advanced breast carcinoma patients who underwent gamma camera imaging for dosimetry and biodistribution studies by using 177 Lu-DOTA-trastuzumab. The standard diagnostic dosimetry protocol was followed, which included cold trastuzumab injection followed by in-house produced 177 Lu-DOTA-trastuzumab. Serial WB planar images (anterior and posterior) were obtained on gamma camera after the infusion of 177 Lu-DOTA-trastuzumab at multiple time points. Whole-body and organ regions of interest were drawn, and the numbers of disintegrations were obtained. The mean absorbed doses for the liver, spleen, kidneys, heart, red marrow, and tumor were obtained from OLINDA EXM v2.1.1 and ORIGIN software. RESULTS: The study included a cohort of 21 female breast carcinoma patients. Tracer activity ( 177 Lu-DOTA-trastuzumab) was noted in the physiological organs such as the liver, spleen, kidneys, heart, as well as in the tumors. On visual analysis of 177 Lu-DOTA-trastuzumab biodistribution, the liver activity showed gradual clearance over time, and although spleen was comparatively faintly visualized than liver and similarly, kidneys were faintly visualized suggestive of the alternate route of tracer excretion. The maximum number of patients (n = 12) showed 2 components of clearance, namely, fast and slow. The average effective half-life of all the patients (including single and 2 components of clearance) was 106.25 ± 22.14 hours (84.11-128.39 hours). The mean absorbed dose for the liver, spleen, kidneys, heart, whole body, and red marrow was 1.0702 ± 0.731, 1.4114 ± 0.462, 1.4232 ± 0.364, 1.4719 ± 0.602, 0.2412 ± 0.0295, and 0.1485 ± 0.0213 mGy/MBq, respectively, by OLINDA EXM and 0.5741 ± 0.333, 0.8096 ± 0.224, 0.7943 ± 0.235, 1.8971 ± 0.713, and 0.09619 ± 0.0144 for liver, spleen, kidneys, heart and whole body respectively by ORIGIN. The absorbed radiation dose for tumor was 1.94E+2 by OLINDA EXM software and 1.78E+2 by ORIGIN software. In this study, during and after infusion of 177 Lu-DOTA-trastuzumab, no major adverse effects were noted in any patient except 1 patient who had grade 1 nausea and managed conservatively by antiemetic drug. CONCLUSIONS: The results of our study demonstrated expected and favorable biodistribution and dosimetry with 177 Lu-DOTA-trastuzumab in HER2-positive breast carcinoma patients. We noticed the mean absorbed dose to the normal organs within the limits of maximum tolerable dose, and also tumor dose was higher than the normal liver dose. Therefore, we conclude that 177 Lu-DOTA-trastuzumab radioimmunotherapy is feasible and a safe treatment option for treating HER2-positive breast carcinoma patients.

Rise of silicene and its applications in gas sensing.

Reviewing a subject is done to provide an insight into theoretical and conceptual background of the study. Looking back into the history of an emerging field and summarizing it in a few pages is a herculean task. Anyway, it was imperative to write a few words about the rise of silicene, its properties, and its applications as gas sensors. Currently, silicene is a growing field of interest. It is probably one of the most studied materials nowadays and scientists and researchers are studying it because of its intriguing electronic properties and potential applications in nanoelectronics. Various experimental and theoretical investigations are going on worldwide to explore the various aspects of this field. It is essential to review the literature based on investigations by various scientists in this field.

Defective GaAs nanoribbon-based biosensor for lung cancer biomarkers: a DFT study.

Density functional theory-based first-principles investigation is performed on pristine and mono vacancy induced GaAs nanoribbons to detect the presence of three volatile organic compounds (VOCs), aniline, isoprene and o-toluidine, which will aid in sensing lung cancer. The study has shown that pristine nanoribbon senses all three analytes. For the pristine structure, we observe decent adsorbing parameters and the bandgap widens after the adsorption of analytes. However, the introduction of the carrier traps induced by defect causes deep energy wells that vary the electrical properties as indicated in the bandgap analysis of GaAs, wherein adsorption of aniline and o-toluidine reduces the bandgap to 0 eV, making the structure highly conductive in nature. The adsorption energies of defect-induced nanoribbon are more as compared with the pristine counterpart. Nonetheless, the introduction of defects has improved the sensitivity further.

Computer assisted orthopaedic surgery: Past, present and future.

Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery, which is why it is surprising that it is not the case for orthopaedic surgery with fewer than 5% of surgeons using available computer technology in their procedures. In this review, we explore the evolution and background of Computer Assisted Orthopaedic Surgery (CAOS), delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found evidence that industry had an important role in driving the discussion at least in knee arthroplasty-a leading field of CAOS-with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Nevertheless, the future of CAOS remains positive with the prospect of new technologies such as improvements in image-guided surgery, enhanced navigation systems, robotics and artificial intelligence.

Robotic-Assisted 3D Bio-printing for Repairing Bone and Cartilage Defects through a Minimally Invasive Approach.

There is an unmet need for new techniques and methods of healing critical size tissue defects, by further reduction of invasiveness in implant, cell and tissue-based surgery. This paper presents the development of a new regenerative medicine that combines 3D bio-printing and robotic-assisted minimally invasive surgery techniques to meet this need. We investigated the feasibility of Remote Centre of Motion (RCM) and viscous material extrusion 3D printing. A hypothetical, intra-articular, regenerative medicine-based treatment technique for focal cartilage defects of the knee was used as a potential example of the application of 3D printing in vivo. The results of this study suggest, that RCM mechanism is feasible with viscous material extrusion 3D printing processes, without a major trade-off in imprint quality. The achieved printing accuracy at an average dimensional error of 0.06 ± 0.14 mm in this new modality of 3D printing is comparable to those described in literature for other types of bio-printing. Robotic assisted 3D bio-printing demonstrated here is a viable option for focal cartilage defect restoration.

Biodistribution and Dosimetry of Indigenously Produced 131I-Rituximab in B-Cell Lymphoma: Pilot Study Estimating Patient-Specific Dose Comparing 2 Different Dosimetric Methods.

Cost containment through indigenous production of radioimmunotherapy agents for non-Hodgkin lymphoma (NHL) would be a pivotal step toward wider clinical availability, especially in developing countries. We examined the biodistribution and dosimetry of indigenously developed and radiolabeled 131I-rituximab, using the monoclonal antibody of chimeric origin, in patients with B-cell lymphoma for potential use in radioimmunotherapy. Methods: This prospective study included 13 patients with B-cell NHL who underwent low-dose diagnostic scanning for dosimetric and biodistribution studies. Soon after rituximab infusion, a diagnostic dose of radioiodinated rituximab was administered. Serial planar whole-body γ-camera images were taken soon afterward and on days 1, 2, 4, and 6. A source of 131I with known activity was used as a reference standard for dosimetry calculations. Results: The patient-specific administered dose that would give a whole-body absorbed radiation dose of 75 cGy, calculated by the MIRD schema, ranged from 3,095.42 to 6,330.33 MBq (83.66-171.09 mCi), with a mean of 3,986.01 ± 863.95 MBq (107.73 ± 23.35 mCi) and a median of 3,697.41 MBq (99.93 mCi). The mean residence time was 69.54 h. Within the first 48 h at least 50% of the injected activity was cleared, and by 144 h at least 80% was cleared. The patient-specific administered dose that would give a whole-body absorbed radiation dose of 75 cGy, calculated by mean residence time and activity-hours, ranged from 2,654.75 to 6,210.45 MBq (71.75-167.85 mCi), with a mean of 3,576.42 ± 927.59 MBq (96.66 ± 25.07 mCi) and a median of 3,421.02 MBq (92.46 mCi). With respect to organ-specific dosimetry, the mean absorbed doses to organs (apart from blood pool [3.77 Gy] and spleen [4.02 Gy]) were 0.97 Gy to the lungs, 0.69 Gy to the liver, and 0.7 Gy to the kidneys. Conclusion: The indigenous product had kinetics similar to commercial radiopharmaceuticals, with the advantage of a lower human antimouse antibody response because of the pharmaceutical's being a chimeric antibody rather than a murine antibody. Hence, clinical administration was safe. In none of the organs did dose-limiting radiation exposure occur at the proposed therapeutic dose.

On the development of a new flexible drill for orthopedic surgery and the forces experienced on drilling bovine bone.

This article presents the construction of a flexible drill which is designed to cut a curved canal in the bone or remove bone materials, to improve the outcome of orthopedic surgery and to facilitate minimally invasive. This article reports the design of the flexible drill and uses it in an experimental rig to evaluate the drilling force generated when cutting bovine bone. The experiments facilitate the measurement of action forces between the mill bits when moving the tip toward or across a bone sample in various configurations caused by bending the flexible drill sheath to enable cutting of a curved path of variable radius in the bone. The reaction force represents the force trying to deflect the mill bit tip away from the bone sample surface and must be resisted in order to continue cutting without deflection or buckling of the tip during the drilling of curved pathways. The experiment shows the flexible drill can cut bones in both configurations and experienced a maximal force of 3.4N in the vertical configuration and 0.54N in lateral configuration. The experimental results show that the flexible drill designed is able to produce sufficient force at variable bending angles to perform the required tasks for bone cutting.

Adsorption and dissociation of sulfur-based toxic gas molecules on silicene nanoribbons: a quest for high-performance gas sensors and catalysts.

The adsorption behavior of sulfur-based toxic gases (H2S and SO2) on armchair silicene nanoribbons (ASiNRs) was investigated using first-principles density functional theory (DFT). Being a zero band gap material, application of bulk silicene is limited in nanoelectronics, despite its high carrier mobility. By restricting its dimensions into one dimension, construction of nanoribbons, and by introduction of a defect, its band gap can be tuned. Pristine armchair silicene nanoribbons (P-ASiNRs) have a very low sensitivity to gas molecules. Therefore, a defect was introduced by removal of one Si atom, leading to increased sensitivity. To deeply understand the impact of the aforementioned gases on silicene nanoribbons, electronic band structures, density of states, charge transfers, adsorption energies, electron densities, current-voltage characteristics and most stable adsorption configurations were calculated. H2S is dissociated completely into HS and H species when adsorbed onto defective armchair silicene nanoribbons (D-ASiNRs). Thus, D-ASiNR is a likely catalyst for dissociation of the H2S gas molecule. Conversely, upon SO2 adsorption, P-ASiNR acts as a suitable sensor, whereas D-ASiNR provides enhanced sensitivity compared with P-ASiNR. On the basis of these results, D-ASiNR can be expected to be a disposable sensor for SO2 detection as well as a catalyst for H2S reduction. Graphical abstract Comparison of I-V characteristics of pristine and defective armchair silicene nanoribbons with H2S and SO2 adsorbed on them.

A Robotic Flexible Drill and Its Navigation System for Total Hip Arthroplasty.

This paper presents a robotic flexible drill and its navigation system for total hip arthroplasty (THA). The new robotic system provides an unprecedented and unique capability to perform curved femoral milling under the guidance of a multimodality navigation system. The robotic system consists of three components. Firstly, a flexible drill manipulator comprises multiple rigid segments that act as a sheath to a flexible shaft with a drill/burr attached to the end. The second part of the robotic system is a hybrid tracking system that consists of an optical tracking system and a position tracking system. Optical tracking units are used to track the surgical objects and tools outside the drilling area, while a rotary encoder placed at each joint of the sheath is synchronized to provide the position information for the flexible manipulator with its virtual object. Finally, the flexible drill is integrated into a computer-aided navigation system. The navigation system provides real time guidance to a surgeon during the procedure. The flexible drill system is then able to implement THA by bone milling. The final section of this paper is an evaluation of the flexible and steerable drill and its navigation system for femoral bone milling in sawbones.

A multi-modality tracking, navigation and calibration for a flexible robotic drill system for total hip arthroplasty.

BACKGROUND: This paper presents a novel multi-modality tracking and navigation system that provides a unique capability to guild a flexible drill tip inside the bone with accurate curved tunnelling. METHODS: As the flexible drill tip cannot be tracked optically inside the bone, this research focuses on developing a hybrid tracking and navigation system for tracking a flexible drill tip by using both optical and kinematic tracking. The tracking information is used to guide the THA (total hip arthroplasty) procedure, providing a real-time virtual model of the flexible drill. RESULTS: The flexible and steerable drill tip system is then tested on total hip arthroplasty followed by evaluation of the positioning and orientation of femoral stem placement by femoral milling. CONCLUSIONS: Based on this study, we conclude that the tracking and navigation system is able to guide the flexible drill to mill inside femoral canal.

Computer assisted navigation in total knee and hip arthroplasty.

INTRODUCTION: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. METHODS: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool. Its advantages include dynamic pre-operative and per-operative assessment, increased accuracy in correction of deformities, kinematics and mechanical axis, a better alignment of components, better survival rates of prostheses and a better functional outcome. Adoption of computer navigation in the hip arthroplasty is still at an early stage compared to knee arthroplasty, though the results are well documented. Evidence suggests improved accuracy in acetabular orientation, positioning, hip offset and leg length correction. RESULTS: Among the orthopaedic surgeons, navigated knee arthroplasty is gaining popularity though slowly. The uptake rates vary from country to country. The Australian joint registry data shows increased navigated knee arthroplasty from 2.4% in 2003 to 28.6% in 2015 and decreased revision rates with navigated knee arthroplasty in comparison with traditional instrumented knee arthroplasty in patient cohort under the age of 55 years. CONCLUSION: Any new technology has a learning curve and with practice the navigation assisted knee and hip arthroplasty becomes easy. We have actively followed the evidence of CAS in orthopaedics and have successfully adopted it in our routine practice over the last decades. Despite the cautious inertia of orthopaedic surgeons to embrace CAS more readily; we are certain that computer technology has a pivotal role in lower limb arthroplasty. It will evolve to become a standard practice in the future in various forms like navigation or robotics.

Dynamic knee behaviour: does the knee deformity change as it is flexed-an assessment and classification with computer navigation.

PURPOSE: The aim of this study was to assess the kinematics of arthritic knees prior to TKA. The hypothesis was that the arthritic knee follows distinct patterns with regard to deformity in coronal plane as it flexes from extended position. METHOD: Data from 585 consecutive arthritic knees that had undergone TKA using two non-image-based navigation systems were included in the study. Coronal plane alignment given by the femoro-tibial mechanical angle (FTMA) was recorded in extension, 30°, 60°, 90° and maximum flexion prior to making any bony cuts or ligamentous releases. RESULTS: Complete data were available for 512 (87.5 %) of arthritic knees. It was found that pre-implant arthritic knees behaved in different distinct patterns from full extension to 90° flexion. These patterns in FTMA from extension through to 90° of flexion were classified into 4 major types (1, 2, 3, and 4) and 8 subgroups (1A, 1B, 2A, 2B, 3, 4A, 4B, 4C) for varus and valgus knees. Beyond 90° of flexion, there were no distinct or consistent patterns. There were differences between varus and valgus knee deformities not only in overall numbers (73.8 % varus vs. 21.1 % valgus) but also in kinematic behaviour. Only 14.1 % of total knees had a consistent deformity (Type 1A) which remained the same throughout the range of flexion. 14.1 % knees actually become opposite deformity as the knee flexes; thus, varus becomes valgus and valgus becomes varus as the knee flexes (Type 3 and 4C). CONCLUSION: This study has observed and categorised distinct patterns which arthritic knees follow in the coronal plane as it flexes. This dynamic change during flexion will have bearing on collateral releases that are traditionally done based on deformity in extension or 90° flexion mainly. This may be the underlying cause of flexion instability especially for Types 3 and 4C knees if collateral soft tissue release is done based on deformity in extension. Full significance of this remains unknown and will need further investigation. LEVEL OF EVIDENCE: III.

Current state of the art in total knee arthroplasty computer navigation.

PURPOSE: Computer-assisted surgery in orthopaedics is passing through the initial adapter phase of technology adoption. It started more than 20 years ago, but the uptake of technology is still not widespread. The purpose of this article is to introduce the reader to the basic technology and familiarize with the terminology used in the computer navigation. METHODS: During this time, the technology has matured and we have the evidence to prove its benefits for patients. Not only does it help placing the prosthetic components in correct orientation, it also helps with other parameters like blood loss and fat embolism reduction. In addition to being a teaching and training tool, it has also opened new areas of research which now question the traditional practices. Since it is not in commonly used, the basic aspects of computer navigation are not very well known. RESULTS: This paper outlines some important definitions and restates the classification of navigation within the spectrum of computer-assisted technologies; it then elaborates on the key principles behind navigation in knee arthroplasty and goes through some of the differences between navigation systems. Finally, it describes in some detail the surgical steps with an image-free knee navigation system. CONCLUSIONS: Computer-assisted navigation is not mainstream yet, but this article should help readers unfamiliar with the technology to understand the basic terms and how it actually works. LEVEL OF EVIDENCE: III.

Leg length discrepancy in computer navigated total hip arthroplasty - how accurate are we?

INTRODUCTION: The success of total hip arthroplasty (THA) depends on the restoration of 2 important parameters - hip offset and leg length. Leg length discrepancy (LLD) after THA is associated with back pain, gait disorder, general patient dissatisfaction and aseptic loosening. Hence it is of utmost importance to minimise LLD. METHODS: This is a retrospective study where we compared the reproduction of leg lengths between navigated THA group (152 patients) and nonnavigated THA group (57 patients). The leg lengths were measured radiologically using Ranawat technique on AP pelvic radiograph. RESULTS: In the navigated group, the leg lengths of the reconstructed hips were restored to within 6 mm of the opposite leg in 146 patients (96.05%) while 6 patients (3.94%) had LLD of more than 6 mm. In the nonnavigated group, 29 patients (51%) had their leg lengths restored within 6 mm of the opposite leg while the remaining 28 patients (49%) had their LLD greater than 6 mm. Statistical analysis of the 2 pairs of LLD measurements (navigated hip and nonnavigated group) using Mann-Whitney U-test revealed significant difference between these two groups (p<0.001). CONCLUSIONS: Based on our results we conclude that computer navigation is an excellent tool to facilitate the successful reproduction of leg length in THA.

Dynamic Knee Alignment and Collateral Knee Laxity and Its Variations in Normal Humans.

Alignment of normal, arthritic, and replaced human knees is a much debated subject as is the collateral ligamentous laxity. Traditional quantitative values have been challenged. Methods used to measure these are also not without flaws. Authors review the recent literature and a novel method of measurement of these values has been included. This method includes use of computer navigation technique in clinic setting for assessment of the normal or affected knee before the surgery. Computer navigation has been known for achievement of alignment accuracy during knee surgery. Now its use in clinic setting has added to the inventory of measurement methods. Authors dispel the common myth of straight mechanical axis in normal knees and also look at quantification of amount of collateral knee laxity. Based on the scientific studies, it has been shown that the mean alignment is in varus in normal knees. It changes from lying non-weight-bearing position to standing weight-bearing position in both coronal and the sagittal planes. It also varies with gender and race. The collateral laxity is also different for males and females. Further studies are needed to define the ideal alignment and collateral laxity which the surgeon should aim for individual knees.

Reproduction of Hip Offset and Leg Length in Navigated Total Hip Arthroplasty: How Accurate Are We?

This study assesses how accurately we can restore hip offset and leg length in navigated total hip arthroplasty (THA). 152 consecutive patients with navigated THA formed the study group. The contra-lateral hip formed control for measuring hip offset and leg length. All radiological measurements were made using Orthoview digital software. In the normal hip offset group, the mean is 75.73 (SD- 8.61). In the reconstructed hip offset group, the mean is 75.35 (SD - 7.48). 95.39% had hip offset within 6 mm of opposite side while 96.04% had leg length restored within 6 mm of contra-lateral side. Equivalence test revealed that the two groups of hip offsets were essentially the same. We conclude that computer navigation can successfully reproduce hip offset and leg length accurately.

Collateral ligament laxity in knees: what is normal?

BACKGROUND: Proper alignment and balancing of soft tissues of the knee are important goals for TKA. Despite standardized techniques, there is no consensus regarding the optimum amount of collateral ligament laxity one should leave at the end of the TKA. QUESTIONS/PURPOSES: I asked (1) what is the collateral laxity in young healthy volunteers, and (2) is there a difference in collateral laxity between males and females. METHODS: The femorotibial mechanical angle (FTMA) was measured in 314 knees in healthy volunteers aged 19 to 35 years. Subjects with a history of pain, malalignment, dysplasia, or trauma were excluded. Twenty-five knees were excluded because the hip center could not be acquired, and 22 were excluded because of a history of pain and trauma, leaving 267 knees for inclusion in the study. Of these, 155 were from men and 112 were from women. A validated method using a computer navigation system was used to obtain the measurements. A 10-Nm torque was used to stress the knee in varus and valgus at 0° extension and 15° flexion. An independent t-test and ANOVA were applied to the data to calculate any significant difference between groups (p<0.05). RESULTS: The mean (SD) unstressed supine FTMA was varus of 1.2° (SD, 4°) in 0° extension and varus of 1.2° (SD, 4.4°) in 15° flexion (p=0.88). On varus torque of 10 Nm, the supine FTMA changed by a mean of 3.1° (SD, 2°) (95% CI, 2.4°-3.8°; p<0.001) in 0° extension and 6.9° (SD, 2.6°) (95% CI, 6.2°-7.7°; p<0.001) in 15° flexion. On valgus torque of 10 Nm, the FTMA changed by a mean of 4.6° (SD, 2.2°) (95% CI, 3.9°-5.3°; p<0.001) in 0° extension and 7.9° (SD, 3.4°) (95% CI, 7.1°-8.7°; p<0.001) in 15° flexion. The mean unstressed FTMA in 0° extension was varus of 1.7° (SD, 4°) in men and 0.4° (SD, 3.9°) in women (p=0.01). Differences in collateral ligament laxity were seen between men and women (p<0.001 for valgus torque and 0.035 for varus torque in 15° flexion). With valgus torque at 0° flexion, the supine FTMA change was valgus of 4.2° (SD, 2.0°) for men and 5.0° (SD, 2.4°) for women, while at 15° flexion the FTMA change was valgus 7.6° (SD, 3.6°) for men and 8.3° (SD, 3.2°) for women With varus torque at 0° flexion, additional varus was -3.0° (SD, 1.8°) for men and -3.3° (SD, 2.2°) for women, while at 15° flexion, varus was -7.0° SD, (2.5°) for men and -6.9° (SD, 2.8°) for women. CONCLUSIONS: The collateral laxity in young healthy volunteers was quantified in this study. The collateral ligament laxity is variable in different persons. In addition, ligaments in women are more lax than in men in valgus stress. CLINICAL RELEVANCE: This study was conducted on young, healthy knees. Whether the findings are applicable to arthritic knees and replaced knees needs additional evaluation. However the findings provide a baseline from which to work in the evaluation of arthritic knees and in the case of TKA.

Photobacterium panuliri sp. nov., an alkalitolerant marine bacterium isolated from eggs of spiny lobster, Panulirus penicillatus from Andaman Sea.

A facultative anaerobe, alkalitolerant, gram-negative marine bacterium strain LBS5(T), was isolated from eggs carried on the pleopods of female spiny lobster (Panulirus penicillatus) in Andaman Sea from a depth of 3.5 m. Heterotrophic growth was observed at 15-38 °C and pH 5.5-11. Optimum growth occurred at 28 °C and pH 7.5. It can grow in the presence of 0.5-7 % NaCl (w/v), and the optimal NaCl required for growth was 2-4 %. 16S rRNA gene sequence analysis revealed the strain LBS5(T) belongs to the genus Photobacterium and showed 99.6 % similarity with P. aquae AE6(T), 98.2 % with P. aphoticum M46(T), 97 % with P. rosenbergii CC1(T), 96.9 % with P. lutimaris DF-42(T), and 96.6 % with P. halotolerans MACL01(T). The DNA-DNA similarities between strains LBS5(T) with other closely related strains were well below 70 %. The DNA G + C content was 50.52 (±0.9) mol%. The major fatty acids were C16:1w7c/w6c, C18:1w6c/w7c, C16:0, C15:0 iso, C16:0 10-methyl/17:1 iso w9c, C17:0 iso. Polar lipids included a phosphatidylglycerol, a diphosphatidylglycerol, a phosphatidylethanolamine, and one unidentified lipid. Based on the polyphasic evidences, strain LBS5(T) represents a novel species of the genus Photobacterium for which Photobacterium panuliri sp. nov. is proposed. The type strain is LBS5(T) (=DSM 27646(T) = LMG 27617(T) = JCM 19199(T)).

Collateral soft tissue release in primary total knee replacement.

The aim of this study was to assess the rate of collateral soft tissue release required in navigated total knee arthroplasty (TKA) to achieve an intra-operative coronal femoral tibial mechanical axis (FTMA) in extension of 0 ± 2°. The primary outcomes assessed were post-operative coronal plane alignment and rate of collateral soft tissue release. The secondary outcomes were range of motion, function, patient satisfaction, and complication rates at one-year follow-up. This is a prospective study of 224 knees. No exclusions were made on the basis of pathology or severity of deformity. Pre-operative FTMA ranged from 27° valgus to 25° varus (mean: -4.5° SD 7.6). Soft tissue release was carried out in 5 of 224 knees (2.2%). Post-operative weight-bearing radiological FTMA ranged from 7° valgus to 8° varus (mean: -0.4° SD 2.5°). Two hundred and ten knees (96%) were within 0 ± 5° of neutral. At one year, median maximum flexion was 100° (IQR 15°) and extension was 0°; mean post-operative Oxford Knee Score had improved from 42 to 23; and 91% of patients were satisfied or very satisfied, with only 2% being dissatisfied. We have found that in the vast majority of cases, including those with large pre-operative coronal deformity in extension, good outcomes in terms of coronal alignment, range of movement, function and patient satisfaction can be achieved.

Anoxybacillus suryakundensis sp. nov, a moderately thermophilic, alkalitolerant bacterium isolated from hot spring at Jharkhand, India.

Four closely related facultative anaerobe, moderately thermophilic, Gram positive rods (JS1(T), JS5, JS11, and JS15) were isolated from sediment samples from a hot spring at Suryakund, Jharkhand, India. Colonies were pale yellow, rough surface with uneven edges on TSA after 72 h incubation. Heterotrophic growth was observed at 40-60°C and pH 5.5-11.5; optimum growth occurred at 55°C and pH 7.5. 16S rRNA gene sequence analysis revealed the strains belong to genus Anoxybacillus. DNA-DNA homology values among strains were above 70% and showed distinct ERIC and REP PCR profile. On the basis of morphology and biochemical characteristics, strain JS1(T) was studied further. Strain JS1(T) showed 99.30% sequence similarity with A. flavithermus subsp. yunnanensis, 99.23% with A. mongoliensis, 99.16% with A. eryuanensis, 98.74% with A. flavithermus subsp. flavithermus, 98.54% with A. tengchongensis, 98.51% with A. pushchinoensis, 97.91% with A. thermarum, 97.82% with A. kaynarcensis, 97.77% with A. ayderensis and A. kamchatkensis, 97.63% with A. salavatliensis, 97.55% with A. kestanbolensis, 97.48% with A. contaminans, 97.27% with A. gonensis and 97.17% with A. voinovskiensis. In 16S rRNA secondary structure based phylogenetic comparison, strain JS1(T) was clustered with Anoxybacillus eryuanensis, A. mongoliensis, and A. flavithermus subsp. yunnanensis and showed 15 species specific base substitutions with maximum variability in helix 6. Moreover, DNA-DNA relatedness between JS1(T) and the closely related type strains were well below 70%. The DNA G+C content was 42.1 mol%. The major fatty acids were C(15:0 iso), C(16:0 iso) and C(17:0iso). The polar lipids were a phosphatidylgylycerol, a diphosphatidylglycerol, a phosphatidylethnolamine, a phosphatidylcholine, a phosphatidyl monomethylethanolamine and four unknown lipids. Based on polyphasic approach, strain JS1(T) represent a novel species of the genus Anoxybacillus for which Anoxybacillus suryakundensis sp. nov. is proposed. The type strain is JS1(T) (= DSM 27374(T) = LMG 27616(T) =JCM19211(T)).