Orthopaedic Manifestations of Thanatophoric Dwarfism: A Case Report.

CASE: We report the rare case of a 3-year-old male patient with thanatophoric dwarfism, a fatal skeletal dysplasia that arises from an autosomal dominant mutation in the fibroblast growth factor receptor 3 gene. The role of the orthopaedic surgeon in the in the management of this disease is discussed. CONCLUSION: We advocate for the close monitoring of disease progression by the orthopaedic surgery team and offer a potential surgical intervention that may help prevent cardiorespiratory demise.

Traumatic abdominal wall injuries-a primer for radiologists.

Traumatic abdominal wall injuries encompass a broad clinical and radiological spectrum and are identified in approximately 9% of blunt trauma patients. The most severe form of abdominal wall injury-a traumatic abdominal wall hernia-is seen in less than 1.5% of blunt abdominal trauma patients. However, the incidence of concurrent intra-abdominal injuries in these patients is high and can result in significant morbidity and mortality. Although the diagnosis of abdominal wall injuries is typically straight forward on CT, associated injuries may distract the interpreting radiologist in more subtle cases. Thus, it is important for the radiologist to identify abdominal wall injuries and their associated injuries on admission CT, as these injuries typically require surgical correction early in the course of their management. Untreated abdominal wall injuries subject the patient to increased risk of delayed bowel incarceration and strangulation. Therefore, it is important for the radiologist to be knowledgeable of injuries to the abdominal wall and commonly associated injuries to provide optimal patient triage and expedite management.

Streamlining emergent hand and wrist radiography with a modified four-view protocol.

This study aims to determine whether a modified four-view hand and wrist study performs comparably to the traditional seven views in the evaluation of acute hand and wrist fractures. This retrospective study was approved by the institutional review board with waiver of informed consent. Two hundred forty patients (50 % male; ages 18-92 years) with unilateral three-view hand (posteroanterior, oblique, and lateral) and four-view wrist (posteroanterior, oblique, lateral, and ulnar deviation) radiographs obtained concurrently following trauma were included in this study. Four emergency radiologists interpreted the original seven images, with two radiologists independently evaluating each study. The patients' radiographs were then recombined into four-view series using the three hand images and the ulnar deviated wrist image. These were interpreted by the same radiologists following an 8-week delay. Kappa statistics were generated to measure inter-observer and inter-method agreement. Generalized linear mixed model analysis was performed between the seven- and four-view methods. Of the 480 reports generated in each of the seven- and four-view image sets, 142 (29.6 %) of the seven-view and 126 (26.2 %) of the four-view reports conveyed certain or suspected acute osseous findings. Average inter-observer kappa coefficients were 0.7845 and 0.8261 for the seven- and four-view protocols, respectively. The average inter-method kappa was 0.823. The odds ratio of diagnosing injury using the four-view compared to the seven-view algorithm was 0.69 (CI 0.45-1.06, P = 0.0873). The modified four-view hand and wrist radiographic series produces diagnostic results comparable to the traditional seven views for acute fracture evaluation.

Multi-detector CT of blunt mesenteric injuries: usefulness of imaging findings for predicting surgically significant bowel injuries.

PURPOSE: The objective of this study is to determine which imaging features of blunt mesenteric injuries best predict the presence of a bowel injury requiring surgical correction. METHODS: The radiology archives at a Level 1 trauma center were searched over a 5-year period to identify patients with mesenteric injuries seen on admission 64 slice MDCT. Two emergency radiologists, blinded to clinical and surgical outcomes, retrospectively recorded mesenteric injury size, the presence/absence of active mesenteric bleeding, bowel wall thickening, adjacent interloop free fluid, extraluminal gas, mesenteric vessel termination, mesenteric vessel "beading", focal bowel wall defect, and bowel wall perfusion abnormality. Based on all of the imaging findings, the radiologists were asked to determine if they thought the patient had a surgical bowel injury. RESULTS: One hundred twenty-six patients with mesenteric injuries were identified. Eighteen patients underwent laparotomy confirming the presence of bowel injury in 15. The remaining patients were successfully managed non-operatively. There was no statistically significant difference in size of mesenteric injury for surgical vs. non-surgical bowel injuries. Active bleeding, adjacent interloop free fluid, and bowel wall perfusion defects were strong predictors of the presence of a surgically significant bowel injury (p < 0.001, 0.002, and 0.020, respectively). The overall accuracy, sensitivity, specificity, PPV, and NPV of 64-MDCT were 73.8%, 80%, 73.0%, 28.6%, and 96.4%, respectively. CONCLUSIONS: Mesenteric active bleeding, adjacent interloop free fluid and bowel wall perfusion defects are associated with surgically significant bowel injuries. The diagnosis of surgical bowel injuries remains challenging despite 64-slice MDCT technology.

Iterative reconstruction improves image quality and preserves diagnostic accuracy in the setting of blunt solid organ injuries.

This study aims to investigate the effect of iterative reconstruction (IR) on MDCT image quality and radiologists' ability to diagnose and grade blunt solid organ injuries. One hundred (100) patients without and 52 patients with solid organ injuries were scanned on a 64-slice MDCT scanner using reference 300 mAs, 120 kVp, and fixed 75 s delay. Raw data was reconstructed using filtered back projection (FBP) and three levels of iterative reconstruction (Philips iDose levels 2, 4, and 6). Four emergency radiologists, blinded to the reconstruction parameters and original interpretation, independently reviewed each case, assessed image quality, and assigned injury grades. Each reader was then asked to determine if they thought that IR was used and, if so, what level. There was no significant difference in diagnostic accuracy between FBP and the various IR levels or effect on the detection and grading of solid organ injuries (p > 0.8). Images reconstructed using iDose level 2 were judged to have the best overall image quality (p < 0.01). The radiologists had high sensitivity in detecting if IR was used (80 %, 95 % CI 76-84 %). IR performed comparably to FBP with no effect on radiologist ability to accurately detect and grade blunt solid organ injuries.

Host plant resistance of cool-season (C3) turfgrasses to above- and belowground feeding by Tipula paludosa (Diptera: Tipulidae).

Feeding on above- and belowground plant tissues by Tipula paludosa Meigen during the period of rapid growth from second to forth instars is highly damaging to cool-season (C3) turfgrasses. It may be possible to reduce this damage by identifying grass genotypes that increase host plant protection. This study examined the impacts of plant genotype, endophyte infection, and plant ontogeny on host plant and insect responses during whole-plant feeding by T. paludosa. A series of no-choice greenhouse trials were conducted with third instar crane flies to determine 1) host plant tolerance in terms of reductions to above- and belowground plant biomass, 2) antixenosis resistance impacting insect behavior (emigration), and 3) antibiosis resistance impacting insect growth. Results showed that insect infestation level was the primary factor influencing plant biomass reductions. Belowground tissues were more tolerant to feeding than were aboveground tissues, with tall fescues, Festuca arundinacea Schreber, being most resistant to aboveground biomass reduction. Host plant associations with intercellular fungal endophytes (E+) decreased insect weight gain and decreased insect movement, but did not increase host plant tolerance. Plant ontogeny affected this response with insect weight gain significantly decreased on young (28 d) growth E+ grasses but not on old (90 d) growth E+ grasses, however. Host plant genotype and plant ontogeny can have significant impacts to host plant tolerance and insect physiology for T. paludosa larva. Furthermore, plant-endophyte associations have apparent sublethal effects that impact insect fitness and may further enhance host plant protection.

Imidacloprid as a contact arrestant for larvae of the European chafer, Amphimallon majale.

BACKGROUND: Manipulative studies of the behavioral response of soil-dwelling insects to insecticides and other antagonists are stymied by the difficulties of observing and interpreting interactions played out below ground. Six experiments were carried out using X-ray radiography to quantify the movement of the European chafer, Amphimallon majale (Razoumowsky), larvae in response to imidacloprid and how this was affected by host plant cues and cold temperature. RESULTS: The movement of third instars was arrested in imidacloprid-treated soil at ≥ 0.6 ppm concentration. At ≥ 0.8 ppm, the arrestant effect of imidacloprid was stronger than the attraction cue posed by germinating grass seed. There was a less disruptive effect on dispersal distance in vertical versus lateral panels. In vertical panels, there was a less disruptive effect on downward movement under a cold temperature treatment that simulated overwintering conditions. CONCLUSION: Larvae of A. majale do not remotely detect imidacloprid in the soil; they neither evade contact, nor are repelled after contact. Imidacloprid thereby acts as a contact arrestant to disrupt grub movement. This finding might help to explain the synergistic effect of imidacloprid in combination with other biological agents for white grub control, and its effects on grub overwintering behavior.

Selecting biological meaningful environmental dimensions of low discrepancy among ranges to predict potential distribution of Bean plataspid invasion.

BACKGROUND: The Bean plataspid (Megacopta cribraria) (Hemiptera: Pentatomidae), native to Asia, is becoming an invasive species in North America; its potential spread to soybean producing areas in the US is of great concern. Ecological niche modelling (ENM) has been used increasingly in predicting invasive species' potential distribution; however, poor niche model transferability was sometimes reported, leading to the artifactual conclusion of niche differentiation during species' invasion. METHODOLOGY/PRINCIPALS: We aim to improve the geographical transferability of ENM via environmental variable selection to predict the potential distribution of Bean plataspid invasion. Sixteen environmental dimensions between native and introduced Bean plataspid populations were compared, and classified into two datasets with different degrees of discrepancy by the interquartile range (IQR) overlap in boxplot. Niche models based on these two datasets were compared in native model prediction and invading model projection. Classical niche model approaches (i.e., model calibrated on native range and transferred outside) were used to anticipate the potential distribution of Bean plataspid invasion. CONCLUSIONS/SIGNIFICANCE: Niche models based on the two datasets showed little difference in native model predictions; however, when projecting onto the introduced area, models based on the environmental datasets showing low discrepancy among ranges recovered good model transferability in predicting the newly established population of Bean plataspid in the US. Recommendations were made for selecting biological meaningful environmental dimensions of low discrepancy among ranges to improve niche model transferability among these geographically separated areas. Outside of its native range, areas with invasion potential include the southeastern US in North America, southwestern Europe, southeastern South America, southern Africa, and the eastern coastal Australia.

Assessing macroinvertebrate biodiversity in freshwater ecosystems: advances and challenges in DNA-based approaches.

Assessing the biodiversity of macroinvertebrate fauna in freshwater ecosystems is an essential component of both basic ecological inquiry and applied ecological assessments. Aspects of taxonomic diversity and composition in freshwater communities are widely used to quantify water quality and measure the efficacy of remediation and restoration efforts. The accuracy and precision of biodiversity assessments based on standard morphological identifications are often limited by taxonomic resolution and sample size. Morphologically based identifications are laborious and costly, significantly constraining the sample sizes that can be processed. We suggest that the development of an assay platform based on DNA signatures will increase the precision and ease of quantifying biodiversity in freshwater ecosystems. Advances in this area will be particularly relevant for benthic and planktonic invertebrates, which are often monitored by regulatory agencies. Adopting a genetic assessment platform will alleviate some of the current limitations to biodiversity assessment strategies. We discuss the benefits and challenges associated with DNA-based assessments and the methods that are currently available. As recent advances in microarray and next-generation sequencing technologies will facilitate a transition to DNA-based assessment approaches, future research efforts should focus on methods for data collection, assay platform development, establishing linkages between DNA signatures and well-resolved taxonomies, and bioinformatics.

Arrival and establishment of Aedes japonicus japonicus (Diptera: Culicidae) in Iowa.

The arrival and establishment of Aedes (Finlaya) japonicus japonicus (Theobald) (Diptera: Culicidae) in Iowa are reported. In total, 518 wild adult specimens were collected through the statewide mosquito and mosquito-borne virus surveillance program in 2007 and 2008. Specimens were collected with New Jersey light traps, CO2-baited CDC light traps, grass infusion-baited gravid traps, and Mosquito Magnet traps located in 12 counties in central and eastern Iowa Specimens were identified morphologically, and identity was further supported by molecular DNA barcoding. Specimens also were tested for infection with West Nile virus (family Flaviviridae, genus Flavivirus, WNV) and La Crosse virus (family Bunyaviridae, genus Bunyavirus, LACV) by reverse transcription-polymerase chain reaction. Although no specimens tested positive for arbovirus infection, the arrival of Ae. j. japonicus in Iowa is a public health concern considering its potential to transmit several arboviruses, particularly WNV and LACV.