The Influence of Shortening on Clinical Outcome in Healed Displaced Midshaft Clavicular Fractures After Nonoperative Treatment.

BACKGROUND: We aimed to evaluate the effect of clavicular shortening, measured with 3-dimensional computed tomography (3DCT), on functional outcomes and satisfaction in patients with healed displaced midshaft clavicular fractures up to 1 year following injury. METHODS: The data used in this study were collected as part of a multicenter, prospective randomized controlled trial of open reduction and plate fixation compared with nonoperative treatment for acute, displaced midshaft clavicular factures. Patients who were randomized to nonoperative treatment and had healed by 1 year were included in the present study. Clavicular shortening relative to the uninjured, contralateral clavicle was measured on 3DCT. Outcome analysis was conducted at 6 weeks, 3 months, 6 months, and 1 year following injury and included the Disabilities of the Arm, Shoulder and Hand (DASH), Constant, and Short Form-12 (SF-12) scores and patient satisfaction. RESULTS: In the original trial, 105 patients were randomized to nonoperative treatment. Thirteen patients were lost to follow-up, leaving 92 patients, and an additional 16 (17%) developed nonunion and were excluded from the present study. Of the remaining 76 patients, 48 who had a 3DCT scan that included the whole length of both clavicles were included in the present study. The shortening of the injured clavicles, relative to the contralateral side, was a mean (and standard deviation) of 11.3 ± 7.6 mm, with a mean proportional shortening of 8%. Proportional shortening did not significantly correlate with the DASH (p ≥ 0.42), Constant (p ≥ 0.32), or SF-12 (p ≥ 0.08) scores at any point during follow-up. There was no significant difference in the mean DASH or Constant scores at any follow-up time point when the cutoff for shortening was defined as 1 cm (p ≥ 0.11) or as 2 cm (p ≥ 0.35). There was no significant difference in clavicular shortening between satisfied and unsatisfied patients (p ≥ 0.49). CONCLUSIONS: The present study demonstrated no association between shortening and functional outcome or satisfaction in patients with healed displaced midshaft clavicular fractures up to 1 year following injury. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The role of the t-SNARE SNAP-25 in action potential-dependent calcium signaling and expression in GABAergic and glutamatergic neurons.

BACKGROUND: The soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) complex, comprised of SNAP-25, syntaxin 1A, and VAMP-2, has been shown to be responsible for action potential (AP)-dependent, calcium-triggered release of several neurotransmitters. However, this basic fusogenic protein complex may be further specialized to suit the requirements for different neurotransmitter systems, as exemplified by neurons and neuroendocrine cells. In this study, we investigate the effects of SNAP-25 ablation on spontaneous neuronal activity and the expression of functionally distinct isoforms of this t-SNARE in GABAergic and glutamatergic neurons of the adult brain. RESULTS: We found that neurons cultured from Snap25 homozygous null mutant (Snap25-/-) mice failed to develop synchronous network activity seen as spontaneous AP-dependent calcium oscillations and were unable to trigger glial transients following depolarization. Voltage-gated calcium channel (VGCC) mediated calcium transients evoked by depolarization, nevertheless, did not differ between soma of SNAP-25 deficient and control neurons. Furthermore, we observed that although the expression of SNAP-25 RNA transcripts varied among neuronal populations in adult brain, the relative ratio of the transcripts encoding alternatively spliced SNAP-25 variant isoforms was not different in GABAergic and glutamatergic neurons. CONCLUSION: We propose that the SNAP-25b isoform is predominantly expressed by both mature glutamatergic and GABAergic neurons and serves as a fundamental component of SNARE complex used for fast synaptic communication in excitatory and inhibitory circuits required for brain function. Moreover, SNAP-25 is required for neurons to establish AP-evoked synchronous network activity, as measured by calcium transients, whereas the loss of this t-SNARE does not affect voltage-dependent calcium entry.

Expression and function of SNAP-25 as a universal SNARE component in GABAergic neurons.

Intracellular vesicular trafficking and membrane fusion are important processes for nervous system development and for the function of neural circuits. Synaptosomal-associated protein 25 kDa (SNAP-25) is a component of neural soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) core complexes that mediate the exocytotic release of neurotransmitters at chemical synapses. Previous results from mouse mutant models and pharmacological/neurotoxin blockades have demonstrated a critical role for SNAP-25-containing SNARE complexes in action potential (AP)-dependent release at cholinergic and glutamatergic synapses and for calcium-triggered catecholamine release from chromaffin cells. To examine whether SNAP-25 participates in the evoked release of other neurotransmitters, we investigated the expression and function of SNAP-25 in GABAergic terminals. Patch-clamp recordings in fetal Snap25-null mutant cortex demonstrated that ablation of SNAP-25 eliminated evoked GABA(A) receptor-mediated postsynaptic responses while leaving a low level of spontaneous AP-independent events intact, supporting the involvement of SNAP-25 in the regulated synaptic transmission of early developing GABAergic neurons. In hippocampal cell cultures of wild-type mice, punctate staining of SNAP-25 colocalized with both GABAergic and glutamatergic synaptic markers, whereas stimulus-evoked vesicular recycling was abolished at terminals of both transmitter phenotypes in Snap25-/- neurons. Moreover, immunohistochemistry and fluorescence in situ hybridization revealed coexpression of SNAP-25, VGAT (vesicular GABA transporter), and GAD65/67 (glutamic acid decarboxylase 65/67) in interneurons within several regions of the adult brain. Our results thus provide evidence that SNAP-25 is critical for evoked GABA release during development and is expressed in the presynaptic terminals of mature GABAergic neurons, consistent with its function as a component of a fundamental core SNARE complex required for stimulus-driven neurotransmission.

Remarkable zeroth-order resonant transmission of microwaves through a single subwavelength metal slit.

A slit in a thick metal plate that is extremely subwavelength will not transmit microwaves polarized parallel to it. It is shown here that cuts perpendicular to the slit allow parallel polarized radiation to resonantly transmit. Furthermore, a zero-order mode may be excited within the slit, the frequency of which, to first order, is independent of the plate depth. Remarkably, for this novel type of resonance, the field in the slit oscillates with a constant phase and little amplitude variation throughout the plate depth, while the resonant wavelength tends to infinity as the slit width approaches zero.

Structurally assisted blackness in butterfly scales.

Surfaces of low reflectance are ubiquitous in animate systems. They form essential components of the visual appearance of most living species and can explicitly influence other biological functions such as thermoregulation. The blackness associated with all opaque surfaces of low reflectivity has until now been attributed to strongly absorbing pigmentation alone. Our present study challenges this assumption, demonstrating that in addition to the requirement of absorbing pigmentation, complex nano-structures contribute to the low reflectance of certain natural surfaces. We describe preliminary findings of an investigation into the nature of the black regions observed on the dorsal wings of several Lepidoptera. Specifically, we quantify the optical absorption associated with black wing regions on the butterfly Papilio ulysses and find that the nanostructure of the wing scales of these regions contributes significantly to their black appearance.

Finite conductance governs the resonance transmission of thin metal slits at microwave frequencies.

Fabry-Perot-like resonant transmission of microwave radiation through a single subwavelength slit in a thick aluminum plate is quantified for a range of slit widths. Surprisingly, and in contrast to previous studies [e.g., Phys. Rev. Lett. 86, 5601 (2001)]], the resonant frequency exhibits a maximum as a function of slit width, decreasing as the slit width is reduced to less than 2% of the incident wavelength. This result accords with a new model based on coupled surface plasmon theory taking into account the finite conductivity, and hence permittivity, of the metal. This is contrary to a common assumption that metals can be treated as infinitely conducting in this regime.

Limited-view iridescence in the butterfly Ancyluris meliboeus.

Few mechanisms exist in nature that effect colour reflectivity, simultaneously high in spectral purity and in intensity, over a strictly limited portion of solid angle above a surface. Fewer still bring about such colour reflectivity with an angle dependence that is distinct from the colour transition associated with conventional multilayer interference. We have discovered that the ventral wings of the butterfly Ancyluris meliboeus exhibit these optical effects, and that they result from remarkable nano-scale architecture on the wing scales of the butterfly. This nano-structure is in the form of high-tilt multilayering that, as a result of abrupt termination of the multilayers, brings about diffraction concurrently with interference. The product is bright structural colour in a limited angular region over the ventral wing surface that enables remarkably strong flicker and colour contrast through minimal wing movement. The visibility effects associated with its colour, in terms of bright and dark zones of the observation hemisphere over the wing surface, are described. We suggest the purpose of the high-contrast ventral wing visibility associated with A. meliboeus is at-rest signalling; this is distinct from the dorsal wing visibility of other species such as those of the genus Morpho, the function of which is largely for in-flight signalling.

Water capture by a desert beetle.

Some beetles in the Namib Desert collect drinking water from fog-laden wind on their backs. We show here that these large droplets form by virtue of the insect's bumpy surface, which consists of alternating hydrophobic, wax-coated and hydrophilic, non-waxy regions. The design of this fog-collecting structure can be reproduced cheaply on a commercial scale and may find application in water-trapping tent and building coverings, for example, or in water condensers and engines.

Surface plasmon resonance studies of immunoreactions utilizing disposable diffraction gratings.

The specificity of protein binding between immuno-gamma globulin (IgG) and anti-IgG has been investigated by means of surface plasmon resonance measurements, with a view to determining whether a perspex replica of a holographic diffraction grating can be used efficiently as the momentum-coupling device. The replicas are easy to fabricate, of low cost, and may be useful as disposable sensing heads in a biosensor. The majority of all published work concerning surface-plasmon-based biosensors has detailed the use of prisms as the momentum-coupling devices. Therefore, the relative advantages and disadvantages of both systems are discussed in this paper, including a sensitive optical technique which is beyond the scope of prism geometries.

Discovery of a new gravitational lens system.

A new gravitational lens system, the triple radio source MG2016+112, has been discovered. Five emission lines at a redshift of 3.2733+/-0.0014 have been identified in the spectra of two stellar objects of magnitude 22.5 coincident with radio components 3.4 arc seconds apart. The lines are the narrowest ever observed in objects at such a large redshift. The redshift of a 23rd-magnitude extended optical object coincident with the third radio component has not been determined spectroscopically, but its known optical properties are consistent with those of a giant elliptical galaxy with a redshift of about 0.8.

Ratio of the concentration of hypoxanthine to creatinine in urine from newborn infants: a possible indicator for the metabolic damage due to hypoxia.

The ratio of the urinary concentrations of the ATP metabolite, hypoxanthine, to that of creatinine was determined in normal newborn infants. An increase in this ratio reflects high hypoxanthine excretion and thus ATP breakdown. The ratio can be determined on random urine samples, thus simplifying sampling. Urinary changes are persistent; abnormalities are detectable on the second day of life after intrapartum hypoxia. Preliminary results suggest that this ratio on a sample during the second day of life could 'diagnose' intrapartum hypoxia and might therefore quantitatively assess those obstetric 'risk factors' believed to operate through hypoxia.