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1.
Nature ; 628(8008): 612-619, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38509366

RESUMEN

There is increasing interest in how immune cells in the meninges-the membranes that surround the brain and spinal cord-contribute to homeostasis and disease in the central nervous system1,2. The outer layer of the meninges, the dura mater, has recently been described to contain both innate and adaptive immune cells, and functions as a site for B cell development3-6. Here we identify organized lymphoid structures that protect fenestrated vasculature in the dura mater. The most elaborate of these dural-associated lymphoid tissues (DALT) surrounded the rostral-rhinal confluence of the sinuses and included lymphatic vessels. We termed this structure, which interfaces with the skull bone marrow and a comparable venous plexus at the skull base, the rostral-rhinal venolymphatic hub. Immune aggregates were present in DALT during homeostasis and expanded with age or after challenge with systemic or nasal antigens. DALT contain germinal centre B cells and support the generation of somatically mutated, antibody-producing cells in response to a nasal pathogen challenge. Inhibition of lymphocyte entry into the rostral-rhinal hub at the time of nasal viral challenge abrogated the generation of germinal centre B cells and class-switched plasma cells, as did perturbation of B-T cell interactions. These data demonstrate a lymphoid structure around vasculature in the dura mater that can sample antigens and rapidly support humoral immune responses after local pathogen challenge.


Asunto(s)
Duramadre , Inmunidad Humoral , Tejido Linfoide , Venas , Administración Intranasal , Antígenos/administración & dosificación , Antígenos/inmunología , Médula Ósea/inmunología , Sistema Nervioso Central/irrigación sanguínea , Sistema Nervioso Central/inmunología , Duramadre/irrigación sanguínea , Duramadre/inmunología , Centro Germinal/citología , Centro Germinal/inmunología , Vasos Linfáticos/inmunología , Tejido Linfoide/irrigación sanguínea , Tejido Linfoide/inmunología , Células Plasmáticas/inmunología , Cráneo/irrigación sanguínea , Linfocitos T/inmunología , Venas/fisiología , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Animales , Ratones , Anciano de 80 o más Años
2.
Plant J ; 118(6): 2169-2187, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38558472

RESUMEN

Genome-wide association studies (GWAS) are an effective approach to identify new specialized metabolites and the genes involved in their biosynthesis and regulation. In this study, GWAS of Arabidopsis thaliana soluble leaf and stem metabolites identified alleles of an uncharacterized BAHD-family acyltransferase (AT5G57840) associated with natural variation in three structurally related metabolites. These metabolites were esters of glucuronosylglycerol, with one metabolite containing phenylacetic acid as the acyl component of the ester. Knockout and overexpression of AT5G57840 in Arabidopsis and heterologous overexpression in Nicotiana benthamiana and Escherichia coli demonstrated that it is capable of utilizing phenylacetyl-CoA as an acyl donor and glucuronosylglycerol as an acyl acceptor. We, thus, named the protein Glucuronosylglycerol Ester Synthase (GGES). Additionally, phenylacetyl glucuronosylglycerol increased in Arabidopsis CYP79A2 mutants that overproduce phenylacetic acid and was lost in knockout mutants of UDP-sulfoquinovosyl: diacylglycerol sulfoquinovosyl transferase, an enzyme required for glucuronosylglycerol biosynthesis and associated with glycerolipid metabolism under phosphate-starvation stress. GGES is a member of a well-supported clade of BAHD family acyltransferases that arose by duplication and neofunctionalized during the evolution of the Brassicales within a larger clade that includes HCT as well as enzymes that synthesize other plant-specialized metabolites. Together, this work extends our understanding of the catalytic diversity of BAHD acyltransferases and uncovers a pathway that involves contributions from both phenylalanine and lipid metabolism.


Asunto(s)
Aciltransferasas , Arabidopsis , Fenilacetatos , Aciltransferasas/genética , Aciltransferasas/metabolismo , Arabidopsis/genética , Arabidopsis/enzimología , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Estudio de Asociación del Genoma Completo , Fenilacetatos/metabolismo
3.
Proc Natl Acad Sci U S A ; 119(33): e2205848119, 2022 08 16.
Artículo en Inglés | MEDLINE | ID: mdl-35939674

RESUMEN

Tetrahydropapaverine (THP) and papaverine are plant natural products with clinically significant roles. THP is a precursor in the production of the drugs atracurium and cisatracurium, and papaverine is used as an antispasmodic during vascular surgery. In recent years, metabolic engineering advances have enabled the production of natural products through heterologous expression of pathway enzymes in yeast. Heterologous biosynthesis of THP and papaverine could play a role in ensuring a stable supply of these clinically significant products. Biosynthesis of THP and papaverine has not been achieved to date, in part because multiple pathway enzymes have not been elucidated. Here, we describe the development of an engineered yeast strain for de novo biosynthesis of THP. The production of THP is achieved through heterologous expression of two enzyme variants with activity on nonnative substrates. Through protein engineering, we developed a variant of N-methylcoclaurine hydroxylase with activity on coclaurine, enabling de novo norreticuline biosynthesis. Similarly, we developed a variant of scoulerine 9-O-methyltransferase capable of O-methylating 1-benzylisoquinoline alkaloids at the 3' position, enabling de novo THP biosynthesis. Flux through the heterologous pathway was improved by knocking out yeast multidrug resistance transporters and optimization of media conditions. Overall, strain engineering increased the concentration of biosynthesized THP 600-fold to 121 µg/L. Finally, we demonstrate a strategy for papaverine semisynthesis using hydrogen peroxide as an oxidizing agent. Through optimizing pH, temperature, reaction time, and oxidizing agent concentration, we demonstrated the ability to produce semisynthesized papaverine through oxidation of biosynthesized THP.


Asunto(s)
Productos Biológicos , Papaverina , Ingeniería de Proteínas , Saccharomyces cerevisiae , Productos Biológicos/metabolismo , Sistema Enzimático del Citocromo P-450/genética , Peróxido de Hidrógeno/química , Oxidantes/química , Papaverina/biosíntesis , Proteínas de Plantas/genética , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/genética
4.
Nat Chem Biol ; 18(7): 762-773, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35668191

RESUMEN

Mucins are large gel-forming polymers inside the mucus barrier that inhibit the yeast-to-hyphal transition of Candida albicans, a key virulence trait of this important human fungal pathogen. However, the molecular motifs in mucins that inhibit filamentation remain unclear despite their potential for therapeutic interventions. Here, we determined that mucins display an abundance of virulence-attenuating molecules in the form of mucin O-glycans. We isolated and cataloged >100 mucin O-glycans from three major mucosal surfaces and established that they suppress filamentation and related phenotypes relevant to infection, including surface adhesion, biofilm formation and cross-kingdom competition between C. albicans and the bacterium Pseudomonas aeruginosa. Using synthetic O-glycans, we identified three structures (core 1, core 1 + fucose and core 2 + galactose) that are sufficient to inhibit filamentation with potency comparable to the complex O-glycan pool. Overall, this work identifies mucin O-glycans as host molecules with untapped therapeutic potential to manage fungal pathogens.


Asunto(s)
Candida albicans , Mucinas , Fucosa , Mucinas/química , Polisacáridos/química , Virulencia
5.
Eur J Orthop Surg Traumatol ; 34(4): 1939-1944, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38472434

RESUMEN

PURPOSE: The number of patients with asymptomatic human immunodeficiency virus (AHIV) is increasing as the efficacy of antiretroviral therapy improves. While there is research on operative risks associated with having HIV, there is a lack of literature describing the impact of well-controlled HIV on postoperative complications. This study seeks to elucidate the impact of AHIV on postoperative outcomes after total hip (THA) and knee (TKA) arthroplasty. METHODS: The Nationwide Inpatient Sample was retrospectively reviewed for patients undergoing TKA and THA from 2005 to 2013. Subjects were subdivided into those with AHIV and those without HIV (non-HIV). Patient demographics, hospital-related parameters, and postoperative complications were all collected. One-to-one propensity score-matching, Chi-square analysis, and multivariate logistical regressions were performed to compare both cohorts. RESULTS: There were no significant differences between AHIV and non-HIV patients undergoing TKA or THA in terms of sex, age, insurance status, or total costs (all, p ≥ 0.081). AHIV patients had longer lengths of stay (4.0 days) than non-HIV patients after both TKA (3.3 days) and THA (3.1 days) (p ≤ 0.011). Both TKA groups had similar postoperative complication rates (p > 0.081). AHIV patients undergoing THA exhibited an increased rate of overall surgical complications compared non-HIV patients (0 vs. 4.5%, p = 0.043). AHIV was not associated with increased complications following both procedures. CONCLUSION: Despite lengthier hospital stays among AHIV patients, baseline AHIV was not associated with adverse outcomes following TKA and THA. This adds to the literature and warrants further research into the impact of asymptomatic, well-controlled HIV infection on postoperative outcomes following total joint arthroplasty.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Tiempo de Internación , Complicaciones Posoperatorias , Puntaje de Propensión , Humanos , Masculino , Femenino , Artroplastia de Reemplazo de Rodilla/efectos adversos , Artroplastia de Reemplazo de Cadera/efectos adversos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Persona de Mediana Edad , Tiempo de Internación/estadística & datos numéricos , Anciano , Infecciones por VIH/complicaciones , Enfermedades Asintomáticas
6.
Lancet Oncol ; 24(1): 107-116, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36509094

RESUMEN

BACKGROUND: Hereditary diffuse gastric cancer, generally caused by germline pathogenic variants in CDH1, presents with early-onset signet ring cell carcinoma. Prophylactic total gastrectomy is the definitive treatment. Endoscopic surveillance can inform the timing of prophylactic total gastrectomy through detection of microscopic signet ring cell carcinoma foci. However, evidence is scarce about the optimal endoscopic sampling technique and characterisation of signet ring cell carcinoma foci in hereditary diffuse gastric cancer. We aimed to formally assess the diagnostic yield of different sampling strategies and to identify criteria for the characterisation of endoscopic lesions. METHODS: For this prospective longitudinal cohort study, we included individuals aged 18 years or older at the Cambridge University Hospitals National Health Service (NHS) Foundation Trust who fulfilled testing criteria for hereditary diffuse gastric cancer between June 1, 2005, and July 31, 2021. The primary outcome was detection of intramucosal signet ring cell carcinoma foci. We assessed the detection rate and anatomical location of signet ring cell carcinoma in random biopsy samples taken according to a systematic protocol compared with biopsies targeted to endoscopic findings. Endoscopic lesions were examined with white-light and narrow band imaging with magnification to assess the likelihood of cancerous foci. FINDINGS: 145 individuals were included, of whom 68 (47%) were male and 92 (63%) carried the CDH1 pathogenic variant. 58 (40%) patients were diagnosed with invasive signet ring cell carcinoma over a median follow-up time of 51 months (IQR 18-80). The first diagnosis of signet ring cell carcinoma was most commonly made from random biopsies (29 [50%] of 58 patients), rather than targeted biopsies (15 [26%] patients). The anatomical distribution of signet ring cell carcinoma foci detected by random biopsies more accurately reflected those identified in prophylactic total gastrectomy specimens than did targeted biopsies. Omitting random biopsies in our cohort would have led to an under-diagnosis rate of 42%. Using a novel panel of endoscopic criteria, gastric lesions containing signet ring cell carcinoma were predicted with a sensitivity of 67·3% and a specificity of 90·2%. INTERPRETATION: Random biopsies enhance the early detection of signet ring cell carcinoma and are complementary to targeted biopsies in surveillance of hereditary diffuse gastric cancer. This sampling method should be the standard of care when performing all surveillance endoscopies for individuals with hereditary diffuse gastric cancer. FUNDING: UK Medical Research Council.


Asunto(s)
Adenocarcinoma , Carcinoma de Células en Anillo de Sello , Neoplasias Gástricas , Humanos , Masculino , Femenino , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Neoplasias Gástricas/cirugía , Estudios Longitudinales , Estudios Prospectivos , Medicina Estatal , Detección Precoz del Cáncer , Biopsia , Carcinoma de Células en Anillo de Sello/diagnóstico , Carcinoma de Células en Anillo de Sello/genética , Carcinoma de Células en Anillo de Sello/cirugía , Gastrectomía , Mutación de Línea Germinal
7.
J Nutr ; 153(2): 470-482, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36894240

RESUMEN

BACKGROUND: Diet is known to affect the gut microbiota and the serum metabolome in adults, but this has not been fully explored in infants. Infancy is an important developmental period that may influence a person's long-term health. Infant development can be affected by diet, which also interacts with the developing gut microbiota. OBJECTIVES: This study aimed to explore the associations between diet, the gut microbiota, and the serum metabolome of 1-y-old infants with the overarching goal of identifying serum biomarkers of diet and/or the gut microbiota. METHODS: We derived dietary patterns of 1-y-old infants (n = 182) participating in the Canadian South Asian Birth Cohort (START) study. We compared gut microbiota α-diversity and ß-diversity and taxa relative abundance from 16S rRNA gene profiles with dietary patterns (PERMANOVA, Envfit) and investigated diet-serum metabolite associations using a multivariate analysis (partial least squares-discriminant analysis) and univariate analysis (t test). We explored the effect of nondietary factors on diet-serum metabolite relationships by incorporating diet, the gut microbiota, and maternal, perinatal, and infant characteristics in a multivariable forward stepwise regression. We replicated this analysis in White European infants, from the CHILD Cohort Study (n = 81). RESULTS: A dietary pattern characterized by formula consumption and negatively associated with breastfeeding most strongly predicted variation in the gut microbiota (R2 = 0.109) and serum metabolome (R2 = 0.547). Breastfed participants showed higher abundance of microbes from the genera Bifidobacterium (3.29 log2-fold) and Lactobacillus (7.93 log2-fold) and higher median concentrations of the metabolites S-methylcysteine (1.38 µM) and tryptophan betaine (0.43 µM) than nonbreastfed participants. Formula consuming infants showed higher median concentrations of branched-chain/aromatic amino acids (average 48.3 µM) than non-formula-consuming infants. CONCLUSIONS: Formula consumption and breastfeeding most strongly predicted the serum metabolites of 1-y-old infants, even when the gut microbiota, solid food consumption, and other covariates were considered.


Asunto(s)
Microbioma Gastrointestinal , Adulto , Embarazo , Femenino , Humanos , Lactante , Estudios de Cohortes , ARN Ribosómico 16S/genética , Heces/microbiología , Canadá , Dieta , Metaboloma
8.
J Comput Assist Tomogr ; 45(4): 629-636, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34519454

RESUMEN

PURPOSE: Immunotherapy has emerged as a treatment option for head and neck squamous cell carcinoma (HNSCC), with tumor response being linked to the CD8+ T-cell inflammation. The purpose of this study is to assess whether computed tomography (CT) radiomic analysis can predict CD8+ T-cell enrichment in HNSCC primary tumors. METHODS: This retrospective study included 71 patients from a head and neck cancer genomics cohort with CD8+ T-cell enrichment status. Pretreatment contrast-enhanced neck CT scans were retrospectively reviewed using 3D Slicer for primary lesion segmentation.The SlicerRadiomics extension was used to extract 107 radiomic features. Ridge regression and lasso regression were applied for feature selection and model construction. RESULTS: Lasso regression defined Coarseness as the most important variable, followed by SmallDependenceEmphasis, SmallAreaLowGrayLevelEmphasis, Contrast.1, and Correlation.Ridge regression defined Coarseness as the most important variable, followed by SmallDependenceLowGrayLevelEmphasis, Contrast.1, DependenceNonUniformityNormalized, and Idmn. These variables identified by lasso and ridge regressions were used to create a combined logistic regression model. The area under the curve (AUC) for the lasso-generated model was 0.786 (95% confidence interval [CI], 0.532-1.000), and the AUC for the ridge-generated model was 0.786 (95% CI, 0.544-1.000). Combining the radiomic variables identified by lasso and ridge regressions with clinical characteristics including alcohol use, tobacco use, anatomic site, and initial T stage produced a model with an AUC of 0.898 (95% CI, 0.731-1.000). CONCLUSIONS: T-cell inflammation status of HNSCC primary tumors can be predicted using radiomic analysis of CT imaging and thereby help identify patients who would respond well to immunotherapy.


Asunto(s)
Linfocitos T CD8-positivos/inmunología , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/inmunología , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico por imagen , Carcinoma de Células Escamosas de Cabeza y Cuello/inmunología , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos
9.
Knee Surg Sports Traumatol Arthrosc ; 29(11): 3621-3632, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33083860

RESUMEN

PURPOSE: Two-stage exchange arthroplasty is considered the gold standard for treatment of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Antibiotic cement spacers can include cement-based spacers (CBS), new components (NEW), and autoclaved components (ACL). The factors that most influence post-reimplantation prosthesis (PRP) survival were determined. METHODS: A retrospective database review of patients undergoing two-stage exchange arthroplasty from 2008 to 2014 was performed. There were 85 patients, 25 patients and 30 patients in CBS, NEW and ACL groups, respectively. Patient, disease and surgical characteristics were collected and analyzed. Post-reimplantation prosthesis (PRP) survival was modeled using the Kaplan-Meier method. Cox proportional hazard modeling was then performed to identify risk factors associated with implant failure. RESULTS: Overall PRP survival was 82% in 140 unilateral TKAs. PRP survival between groups was 81%, 96% and 73% within the minimum 2-year follow-up period, respectively. There was a difference in median interval-to-reimplantation between groups (CBS, 72.0 days; NEW, 111.0 days; ACL, 84.0 days, p = 0.003). Adjusting for time-to-reimplantation, NEW spacers demonstrated greater PRP survival compared with ACL spacers (p = 0.044), and a trend towards greater survival compared with CBS spacers (p = 0.086). Excluding early failures (< 90 days), NEW spacers still demonstrated greater survival than ACL spacers (p = 0.046). Lower volume (≤ 10 within this series) surgeons tended to use more CBS spacers, while higher volume surgeons were comfortable with ACL spacers. CONCLUSIONS: There was greater PRP survival with NEW spacers. NEW spacers also demonstrated an increased inter-stage interval, likely because of increased comfort and motion. There were spacer choice differences between low- and high-volume surgeons. LEVEL OF EVIDENCE: III.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Infecciones Relacionadas con Prótesis , Antibacterianos/uso terapéutico , Artroplastia de Reemplazo de Rodilla/efectos adversos , Humanos , Articulación de la Rodilla/cirugía , Prótesis de la Rodilla/efectos adversos , Falla de Prótesis , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Infecciones Relacionadas con Prótesis/cirugía , Reoperación , Reimplantación , Estudios Retrospectivos , Resultado del Tratamiento
11.
J Comput Assist Tomogr ; 44(4): 546-552, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32697524

RESUMEN

PURPOSE: To determine the relationship between computed tomography (CT) radiomic features and gene expression levels in head and neck squamous cell carcinoma (HNSCC). METHODS: This retrospective study included 66 patients with HNSCC primary lesions (36 oropharyngeal, 6 hypopharyngeal, 10 laryngeal, 14 oral cavity). Gene expression information for 6 targetable genes (fibroblast growth factor receptor [FGFR]1, epidermal growth factor receptor [EGFR], FGFR2, FGFR3, EPHA2, PIK3CA) was obtained via Agilent microarrays from samples collected between 1997 and 2010. Pretreatment contrast-enhanced soft tissue neck CT scans were reviewed, and 142 radiomics features were derived. R was used to calculate Pearson correlation coefficients were calculated between gene expression levels and each radiomic feature. P values were adjusted using the false discovery rate (FDR) method. RESULTS: There were significant correlations between FGFR1 and 5 gray level cooccurrence matrix (GLCM) features with FDR-adjusted P values less than 0.05: inertia (r = 0.366, FDR-adjusted P = 0.006), absolute value (r = 0.31, FDR-adjusted P = 0.024), contrast (r = 0.366, FDR-adjusted P = 0.006), difference average (r = 0.31, FDR-adjusted P = 0.024), and difference variance (r = 0.37, FDR-adjusted P = 0.005). There was 1 correlated feature for FGFR2 with an FDR-adjusted P value less than 0.05: fractal dimension box-coarse (r = 0.33, FDR-adjusted P = 0.018). There was 1 correlated feature for EPHA2 with an FDR-adjusted P value less than 0.05: GLCM entropy (r = -0.28, FDR-adjusted P = 0.049). Six of the 7 features that showed significant correlation belonged to the GLCM class of features. CONCLUSIONS: The CT radiomic features demonstrate correlations with FGFR1 status in HNSCC and should be further investigated for their potential to predict FGFR1 status.


Asunto(s)
Fosfatidilinositol 3-Quinasa Clase I/genética , Efrina-A2/genética , Perfilación de la Expresión Génica/métodos , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Receptores de Factores de Crecimiento de Fibroblastos/genética , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Receptores ErbB/genética , Femenino , Regulación Neoplásica de la Expresión Génica , Neoplasias de Cabeza y Cuello/genética , Humanos , Masculino , Persona de Mediana Edad , Medicina de Precisión , Interpretación de Imagen Radiográfica Asistida por Computador , Receptor EphA2 , Receptor Tipo 1 de Factor de Crecimiento de Fibroblastos/genética , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Receptor Tipo 3 de Factor de Crecimiento de Fibroblastos/genética , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello/genética , Tomografía Computarizada por Rayos X/métodos
12.
J Arthroplasty ; 35(4): 1117-1122, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31836326

RESUMEN

BACKGROUND: We investigated the effect of taper design, head material, and manufacturer on simulated mechanically assisted crevice corrosion (MACC). METHODS: Six pristine C-taper stems coupled with alumina-zirconia or cobalt-chromium (CoCr) heads were tested in a mechanical/electrochemical setup to measure average fretting currents and fretting current onset loads. Outcomes were compared with previous data from V40 tapers from the same manufacturer and 12/14 tapers from another manufacturer. RESULTS: Within a single manufacturer, differences in average fretting current between V40 and C-taper designs were dependent on head material. Only with V40 tapers did CoCr heads show higher average fretting currents than ceramic heads. Between manufacturers, differences were found between similar taper designs, as 12/14 taper couples showed higher average fretting currents than C-taper couples, regardless of head material. CONCLUSION: Taper design, head material, and factors inherent to different manufacturers influence fretting current in simulated MACC. Unlike clinical and retrieval studies, this experimental design allows for investigations of factors affecting MACC in a controlled environment. Taper design, independent of manufacturer, contributes to the observed differences in average fretting current between head materials. In some taper designs, head composition, specifically ceramic, should not be considered alone to reduce risk of corrosion.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Prótesis de Cadera , Corrosión , Humanos , Diseño de Prótesis , Falla de Prótesis
13.
BMC Microbiol ; 19(1): 214, 2019 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-31488062

RESUMEN

BACKGROUND: Characterization of the skin and wound microbiome is of high biomedical interest, but is hampered by the low biomass of typical samples. While sample preparation from other microbiomes (e.g., gut) has been the subject of extensive optimization, procedures for skin and wound microbiomes have received relatively little attention. Here we describe an improved method for obtaining both phage and microbial DNA from a single skin or wound swab, characterize the yield of DNA in model samples, and demonstrate the utility of this approach with samples collected from a wound clinic. RESULTS: We find a substantial improvement when processing wound samples in particular; while only one-quarter of wound samples processed by a traditional method yielded sufficient DNA for downstream analysis, all samples processed using the improved method yielded sufficient DNA. Moreover, for both skin and wound samples, community analysis and viral reads obtained through deep sequencing of clinical swab samples showed significant improvement with the use of the improved method. CONCLUSION: Use of this method may increase the efficiency and data quality of microbiome studies from low-biomass samples.


Asunto(s)
Microbiota/genética , Piel/microbiología , Manejo de Especímenes/métodos , Heridas y Lesiones/microbiología , Bacterias/genética , Bacteriófagos/genética , ADN Bacteriano/genética , ADN Bacteriano/aislamiento & purificación , ADN Viral/genética , ADN Viral/aislamiento & purificación , Humanos , Límite de Detección , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN , Piel/patología , Heridas y Lesiones/patología
14.
Int Orthop ; 43(7): 1611-1620, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-30617612

RESUMEN

PURPOSE: Patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA) are accepted treatments for end-stage isolated patellofemoral osteoarthritis (PFOA). However, complications and re-operations have historically differed between the two procedures. We performed a systematic review to report on the re-operation rates between TKA and modern PFA for isolated PFOA. METHODS: Systematically identified publications reporting on patients that underwent either TKA or modern PFA for isolated PFOA were reviewed. Meta-analysis software was used to screen potential articles with at least one year follow-up that detailed reasons for re-operation. Data was extracted and analyzed for all re-operations. Survival of the implant was used as the primary outcome; return to the operating room (OR) for any reason was used as a secondary outcome. RESULTS: The weighted rate of either conversion or revision arthroplasty in the PFA group and the TKA group was 6.34 and 0.11, respectively. The weighted rate of return to the OR for bony and soft tissue procedures was 1.06 and 0.79, respectively. The weighted rate of manipulation under anaesthesia (MUA) was 0.32 and 1.23, respectively. CONCLUSION: Patients who undergo PFA may be more likely to return to the operating room for conversion to TKA and/or revision surgery than those who undergo TKA.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/efectos adversos , Artroplastia de Reemplazo de Rodilla/métodos , Osteoartritis de la Rodilla/cirugía , Articulación Patelofemoral/cirugía , Reoperación , Humanos , Articulación de la Rodilla/cirugía , Resultado del Tratamiento
15.
Eur Spine J ; 27(Suppl 3): 403-408, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29103128

RESUMEN

PURPOSE: To describe the manifestations, surgical treatment, and potential complications of Hajdu-Cheney syndrome (HCS), and the management of these complications. METHODS: The clinical presentation, management and outcome of HCS with severe osteoporosis and open skull sutures is presented, together with a literature review. RESULTS: A 20-year-old female with HCS underwent posterior occipitocervical fusion for symptoms of progressive basilar invagination. Because of delayed lambdoid suture closure, the stiff fusion construct lead to increased suture distraction, most notably in the upright (suture-open) position, with relief in the supine (suture-closed) position. This was successfully remedied with extension of the fusion construct anteriorly over the skull vertex to the frontal bones. CONCLUSIONS: In patients with HCS and other conditions with delayed suture closure, the surgeon must be cognizant of the presence of mobility at the suture lines, and consider extending the fusion construct anteriorly over the skull vertex up to the frontal bones. Because of significant osteoporosis in these syndromes, multiple fixation points and augmentation with bone graft are important principles.


Asunto(s)
Suturas Craneales/anomalías , Síndrome de Hajdu-Cheney/complicaciones , Cifosis/etiología , Osteoporosis/complicaciones , Fusión Vertebral/efectos adversos , Adulto , Craneotomía/efectos adversos , Craneotomía/métodos , Femenino , Síndrome de Hajdu-Cheney/cirugía , Humanos , Cifosis/cirugía , Laminectomía/efectos adversos , Laminectomía/métodos , Imagen por Resonancia Magnética , Osteoporosis/cirugía , Platibasia/etiología , Fusión Vertebral/métodos , Tomografía Computarizada por Rayos X , Adulto Joven
16.
Mycorrhiza ; 28(4): 343-356, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29574496

RESUMEN

Understanding how soil pedogenesis affects microbial communities and their in situ activities according to ecosystem functioning is a central issue in soil microbial ecology, as soils represent essential nutrient reservoirs and habitats for the biosphere. To address this question, soil chronosequences developed from a single, shared mineralogical parent material and having the same climate conditions are particularly useful, as they isolate the factor of time from other factors controlling the character of soils. In our study, we considered a natural succession of uplifted marine terraces in Mendocino, CA, ranging from highly fertile in the younger terrace (about 100,000 years old) to infertile in the older terraces (about 300,000 years old). Using ITS amplicon pyrosequencing, we analysed and compared the diversity and composition of the soil fungal communities across the first terraces (T1 to T3), with a specific focus in the forested terraces (T2 and T3) on soil samples collected below trees of the same species (Pinus muricata) and of the same age. While diversity and richness indices were highest in the grassland (youngest) terrace (T1), they were higher in the older forested terrace (T3) compared to the younger forested terrace (T2). Interestingly, the most abundant ectomycorrhizal (ECM) taxa that we found within these fungal communities showed high homology with ITS Sanger sequences obtained previously directly from ECM root tips from trees in the same study site, revealing a relative conservation of ECM diversity over time. Altogether, our results provide new information about the diversity and composition of the fungal communities as well as on the dominant ECM species in the soil chronosequence of Mendocino in relation to soil age and ecosystem development.


Asunto(s)
Hongos/clasificación , Microbiota , Microbiología del Suelo , Suelo/clasificación , California , ADN de Hongos/análisis , Micorrizas/clasificación , Micorrizas/aislamiento & purificación , Análisis de Secuencia de ADN
17.
Appl Environ Microbiol ; 83(5)2017 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-28003192

RESUMEN

Although minerals represent important soil constituents, their impact on the diversity and structure of soil microbial communities remains poorly documented. In this study, pure mineral particles with various chemistries (i.e., obsidian, apatite, and calcite) were considered. Each mineral type was conditioned in mesh bags and incubated in soil below different tree stands (beech, coppice with standards, and Corsican pine) for 2.5 years to determine the relative impacts of mineralogy and mineral weatherability on the taxonomic and functional diversities of mineral-associated bacterial communities. After this incubation period, the minerals and the surrounding bulk soil were collected to determine mass loss and to perform soil analyses, enzymatic assays, and cultivation-dependent and -independent analyses. Notably, our 16S rRNA gene pyrosequencing analyses revealed that after the 2.5-year incubation period, the mineral-associated bacterial communities strongly differed from those of the surrounding bulk soil for all tree stands considered. When focusing only on minerals, our analyses showed that the bacterial communities associated with calcite, the less recalcitrant mineral type, significantly differed from those that colonized obsidian and apatite minerals. The cultivation-dependent analysis revealed significantly higher abundances of effective mineral-weathering bacteria on the most recalcitrant minerals (i.e., apatite and obsidian). Together, our data showed an enrichment of Betaproteobacteria and effective mineral-weathering bacteria related to the Burkholderia and Collimonas genera on the minerals, suggesting a key role for these taxa in mineral weathering and nutrient cycling in nutrient-poor forest ecosystems.IMPORTANCE Forests are usually developed on nutrient-poor and rocky soils, while nutrient-rich soils have been dedicated to agriculture. In this context, nutrient recycling and nutrient access are key processes in such environments. Deciphering how soil mineralogy influences the diversity, structure, and function of soil bacterial communities in relation to the soil conditions is crucial to better understanding the relative role of the soil bacterial communities in nutrient cycling and plant nutrition in nutrient-poor environments. The present study determined in detail the diversity and structure of bacterial communities associated with different mineral types incubated for 2.5 years in the soil under different tree species using cultivation-dependent and -independent analyses. Our data showed an enrichment of specific bacterial taxa on the minerals, specifically on the most weathered minerals, suggesting that they play key roles in mineral weathering and nutrient cycling in nutrient-poor forest ecosystems.


Asunto(s)
Bacterias/clasificación , Bosques , Consorcios Microbianos , Minerales/análisis , Microbiología del Suelo , Suelo/química , Árboles/microbiología , Bacterias/genética , Bacterias/aislamiento & purificación , Betaproteobacteria/clasificación , Biodiversidad , Burkholderia/clasificación , ADN Bacteriano/genética , Ecosistema , Francia , Oxalobacteraceae/clasificación , Filogenia , ARN Ribosómico 16S/genética , Especificidad de la Especie , Árboles/química
18.
Microb Ecol ; 72(2): 428-42, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27138048

RESUMEN

Understanding how minerals affect bacterial communities and their in situ activities in relation to environmental conditions are central issues in soil microbial ecology, as minerals represent essential reservoirs of inorganic nutrients for the biosphere. To determine the impact of mineral type and solution chemistry on soil bacterial communities, we compared the diversity, composition, and functional abilities of a soil bacterial community incubated in presence/absence of different mineral types (apatite, biotite, obsidian). Microcosms were prepared containing different liquid culture media devoid of particular essential nutrients, the nutrients provided only in the introduced minerals and therefore only available to the microbial community through mineral dissolution by biotic and/or abiotic processes. By combining functional screening of bacterial isolates and community analysis by bromodeoxyuridine DNA immunocapture and 16S rRNA gene pyrosequencing, we demonstrated that bacterial communities were mainly impacted by the solution chemistry at the taxonomic level and by the mineral type at the functional level. Metabolically active bacterial communities varied with solution chemistry and mineral type. Burkholderia were significantly enriched in the obsidian treatment compared to the biotite treatment and were the most effective isolates at solubilizing phosphorous or mobilizing iron, in all the treatments. A detailed analysis revealed that the 16S rRNA gene sequences of the OTUs or isolated strains assigned as Burkholderia in our study showed high homology with effective mineral-weathering bacteria previously recovered from the same experimental site.


Asunto(s)
Bacterias/clasificación , Microbiología del Suelo , Suelo/química , Bacterias/aislamiento & purificación , Bioensayo , Bromodesoxiuridina , ADN Bacteriano/genética , Concentración de Iones de Hidrógeno , Minerales/análisis , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN
19.
J Arthroplasty ; 31(11): 2408-2414, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27259393

RESUMEN

BACKGROUND: Both the prevalence of obesity and the utilization rate of total knee arthroplasty are increasing. The rate and proportion of total knee arthroplasty (TKA) performed in the setting of obesity/morbid obesity is increasing significantly over time. METHODS: Using International Classification of Diseases-Ninth Revision codes, we searched the National Hospitals Discharge Survey national database for patients admitted for primary TKA between 2001 and 2010. We then used International Classification of Diseases-Ninth Revision codes for obesity (body mass index = 30-40 kg/m2) and morbid obesity (body mass index, ≥ 40 kg/m2) to select the obese cohorts. RESULTS: We found 29,694 nonobese, 2645 obese, and 1150 morbidly obese patients. There was an increase in each group over time. The rate of obesity/morbid obesity was strongly correlated with time. Obese and morbidly obese patients were more likely to be younger, female, diabetic, and have Medicaid than nonobese patients. Obese and morbidly obese patients had shorter hospital stays and higher home discharge rates than nonobese patients. Obese and morbidly obese patients had lower transfusion rates, shorter hospital stays, and no increase in inpatient wound infection or venous thromboembolic complications than nonobese patients. The Midwest region saw a greater burden of obese TKA patients. CONCLUSION: With the right measures and precautions, satisfactory inhospital outcomes are possible in the obese patient after primary TKA. A limitation of this study is short inhospital stay of the index procedure as complications may present later after discharge.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/estadística & datos numéricos , Obesidad Mórbida/epidemiología , Anciano , Femenino , Hospitales , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Alta del Paciente , Resultado del Tratamiento , Estados Unidos/epidemiología
20.
J Hand Surg Am ; 39(1): 65-74, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24246756

RESUMEN

PURPOSE: Injuries involving the tendon-bone interface (TBI) are difficult to address. Standard techniques typically lead to diminished strength of the healed insertion site. We hypothesized that these injuries would benefit from being reconstructed with decellularized composite grafts replacing both tendon and bone. To test this hypothesis, decellularized grafts were compared with conventional pullout repairs in an in vivo animal model. METHODS: We harvested 48 Achilles TBI grafts from rats and decellularized them. Tendon-bone interface graft reconstruction and pullout repairs were compared using a pair-matched design. Biomechanical properties were evaluated at 2, 4, 8, and 12 weeks. We evaluated histological analysis of insertion morphology and collagen type I/III content. RESULTS: There was a significant increase in ultimate failure load (35 ± 11 vs 24 ± 7 N) and ultimate tensile stress (1.5 ± 0.3 vs 1.0 ± 0.4 N/mm(2)) of the TBI grafts compared with pullout repairs at 2 weeks. These differences remained at 4 weeks. At 12 weeks, both TBI grafts and pullout repairs were as strong as native tissue and not significantly different from each other. Histology showed a more organized extracellular matrix in the TBI graft group at the early time points. Repopulation of the decellularized grafts increased over time. At 12 weeks, the insertion points of both groups were richly populated with cells that possessed morphologies similar to those found in native TBI. CONCLUSIONS: This study showed that decellularized TBI grafts were stronger compared with conventional pullout repairs at 2 and 4 weeks but were comparable at 12 weeks. A more organized extracellular matrix and different collagen composition in the early time points may explain the observed differences in strength. CLINICAL RELEVANCE: In the future, decellularized TBI grafts may be used to reconstruct tendon-bone insertion tears in multiple areas including the flexor tendon system.


Asunto(s)
Trasplante Óseo/métodos , Aloinjertos Compuestos , Traumatismos de la Mano/cirugía , Tendones/trasplante , Tenodesis/métodos , Animales , Fenómenos Biomecánicos , Aloinjertos Compuestos/patología , Aloinjertos Compuestos/fisiopatología , Modelos Animales de Enfermedad , Humanos , Ratones , Falla de Prótesis , Ratas , Ratas Wistar , Tendones/patología , Tendones/fisiopatología , Recolección de Tejidos y Órganos
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