Assessment of Functional and Radiological Outcomes of Comminuted Intra-Articular Distal Radius Fracture Treated With Locking Compression Plate.

Background Distal radial fractures (DRFs) are a prevalent form of skeletal injuries that hinder a person from performing daily living activities. Although several treatment modalities have been established to manage DRF, an optimal intervention has not been identified for comminuted fractures. The use of locking compression plates (LCPs) is gaining popularity for fractures that cannot be anatomically reduced because they offer better stability and early recovery. Thus, this study aims to investigate the surgical outcome of comminuted intra-articular DRFs treated with LCPs. Methodology We performed open reduction and internal fixation in 30 patients (18 males and 12 females) with DRF and were followed up at regular intervals following the surgery (at three, six, twelve, and twenty-four weeks). The surgical outcome was assessed both from functional and radiological standpoints. The influence of LCP on functional outcome was evaluated based on the modified Mayo wrist score and the quality of reduction based on the Lindstrom criteria by observing volar tilt and radial inclination. Results For radiological outcome, there was no variation in tilt/inclination of more than two degrees even after three months, which was a satisfactory result. Moreover, patients of all age groups showed early range of motion and functional benefit from LCP treatment. After six months of treatment, the patients experienced no pain and were able to return to their pre-injury jobs with little difficulty. Range of motion, work status, and grip strength after six months showed improvement of 15%, 7.8%, and 56%, respectively, compared to immediate postoperative assessments at three weeks. Although the end outcome with any treatment modality may yield similar results, when using LCPs, most patients experienced early functional improvement nearly six months after surgery. Conclusions By offering a lower risk of complications and early functional mobility, LCPs tend to restore the articular architecture of the fractured joint that results in the desired range of motion, grip strength, improved pain management, and functional status. Thus, LCPs appear to be a better alternative for distal end radial fractures than other treatment modalities.

Age-dependent changes of fat body stores and the regulation of fat body lipid synthesis and mobilisation by adipokinetic hormone in the last larval instar of the cricket, Gryllus bimaculatus.

Data on the hormonal regulation of the formation and mobilisation of fat body stores are presented and discussed in relation to general parameters of last instar larval development such as growth, food intake, and moulting. Crickets feed voraciously during the first half of the last larval stage. With the onset of feeding, fat body lipid synthesis increases, leading to increasing lipid stores in the fat body with a maximum reached on day 5. Lipid (42% of fat body fresh mass) is the main constituent of the fat body stores, followed by protein (6%) and glycogen (2%). During the second half of the last larval stage, feeding activity dramatically decreases, the glycogen reserves are depleted but lipid and protein reserves in the fat body remain at a high level except for the last day of the last larval stage when lipid and protein in the fat body are also largely depleted. The process of moulting consumes almost three quarters of the caloric equivalents that were acquired during the last larval stage. Adipokinetic hormone (AKH) inhibits effectively the synthesis of lipids in the larval fat body. Furthermore, AKH stimulates lipid mobilisation by activating fat body triacylglycerol lipase (TGL) in last larval and adult crickets. Both effects of AKH are weaker in larvae than in adults. This is the first report on the age-dependent basal activity of TGL in larval and adult insects. In addition, for the first time, an activation of TGL by AKH in a larval insect is shown.

Tissue and stage-specific juvenile hormone esterase (JHE) and epoxide hydrolase (JHEH) enzyme activities and Jhe transcript abundance in lines of the cricket Gryllus assimilis artificially selected for plasma JHE activity: implications for JHE microevolution.

Fat body and midgut juvenile hormone esterase (JHE) and juvenile hormone epoxide hydrolase (JHEH) specific activities, and plasma JHE activity, were measured throughout the last stadium in two pairs (blocks) of lines of the cricket Gryllus assimilis, each pair of which had been artificially selected for high- or low-plasma JHE activity. Highly significant differences were observed between high- and low-activity lines of each block on most days for fat body JHE, and on one day for midgut JHE activity. In each block, line differences in developmental profiles for fat body JHE activity paralleled line differences in plasma JHE activity during the early-mid stadium, but not during the latter part of the stadium. The developmental profile of midgut JHE activity differed from that of plasma and fat body JHE activity, exhibiting peaks during the early and latter parts of the stadium. Midgut and fat body JHEH activities exhibited a mid-stadium peak in all lines, but activities were very similar in all lines. Fat body JHE appears to be a more significant contributor to plasma JHE than is midgut JHE. During the middle of the last stadium (day 4), Jhe transcript abundance was significantly higher in fat body or midgut of high- vs. low-JHE-activity lines. Jhe transcript abundance was positively correlated with JHE enzyme activity in either fat body or midgut, and with plasma JHE activity. Natural populations of G. assimilis harbor genetic variation for Jhe gene expression which appears to contribute to genetic variation in JHE specific activity in fat body and midgut. These genes appear to have been the targets of artificial selection that resulted in lines that differ dramatically in high- or low-plasma JHE activity. These genes appear to have little, if any, pleiotropic effects on JHEH specific activity.

Changes in the biochemical composition of fat body stores during adult development of female crickets, Gryllus bimaculatus.

Age-dependent changes in the fat body composition and aspects of lipogenesis in the free abdominal fat body of female crickets, Gryllus bimaculatus, were studied. Lipid, protein, glycogen, and free carbohydrate content of the fat body, and fat body wet weight increased simultaneously and sharply from day 0 onwards and were doubled/almost doubled by day 2 after adult emergence. Lipogenic activity of the fat body, fat body weight, and the energy stores in the fat body peaked on day 2, except for free carbohydrate, which peaked on day 3. On day 2, the fat body was mainly comprised of lipid (53.8%) and protein (6.6%), while glycogen and free carbohydrate together contributed less than 1% of the fat body wet weight. After peaking, both lipogenesis and energy stores decreased in a synchronous manner. The depletion of the fat body energy stores and the consequent decrease in the fat body weight were concomitant with a fast and massive gain in ovary weight (day 2: 19.5 +/- 1.5 mg; day 4: 332.8 +/- 31.5 mg) due to the vitellogenic oocyte growth that started on day 2. Our data clearly underline the importance of the free abdominal fat body as a source of energy for reproduction in the cricket. Fat body fatty acid synthase activity coincided with lipogenic activity. Adipokinetic hormone inhibits lipid synthesis in the fat body, but treatment of the fat body with adipokinetic hormone in vitro showed no consistent effect on fatty acid synthase activity.