A novel approach for joint line restoration in revision total ankle arthroplasty based on the three-dimensional registration of the contralateral tibia and fibula.

PURPOSE: The use of total ankle arthroplasty (TAA) is increasing over time, as so will the need for revision TAAs in the future. Restoration of the ankle joint line (JL) in revision TAA is often difficult due to severe bone loss. This study analyzed the accuracy of a three-dimensional (3D) registration of the contralateral tibia and fibula to restore the ankle joint line (JL) and reported side-to-side differences of anatomical landmarks. METHODS: 3D triangular surface models of 96 paired lower legs underwent a surface registration algorithm for superimposition of the mirrored contralateral lower leg onto the original lower leg to approximate the original ankle JL using a proximal, middle and distal segment. Distances of the distal fibular tip, anterior and posterior medial colliculus to the JL were measured and absolute side-to-side differences reported. Anterior lateral distal tibial angle (ADTA) and lateral distal tibial angle (LDTA) were measured. RESULTS: Mean JL approximation was most accurate for the distal segment (0.1 ± 1.4 mm (range: -3.4 to 2.8 mm)) and middle segment (0.1 ± 1.2 mm (range: -2.8 to 2.5 mm)) compared to the proximal segment (-0.2 ± 1.6 mm (range: -3.0 to 4.9 mm)) (p = 0.007). Distance of the distal fibular tip, the anterior, and posterior medial colliculus to the JL, ADTA and LDTA yielded no significant side-to-side differences (n.s.). CONCLUSION: 3D registration of the contralateral tibia and fibula reliably approximated the original ankle JL. The contralateral distal fibular tip, anterior and posterior medial colliculi, ADTA and LDTA can be used reliably for the planning of revision TAA with small side-to-side differences reported. LEVEL OF EVIDENCE: IV.

Chemokine Patterns in Children with Acute Bacterial Infections.

Chemokines are chemotactic cytokines that are mainly involved in the migratory patterns of immune cells. Few studies have evaluated the levels of chemokines in children with acute bacterial infections. The aim of this study was to evaluate the serum levels of chemokines MCP-1, RANTES, MIG and IP-10 in children with sepsis, community-acquired pneumonia (CAP) and skin abscess. Serum levels of MCP-1, RANTES, MIG and IP-10 were measured in 37 children with sepsis, 27 children with CAP, 25 children with skin abscess and 20 controls with no signs of infection. Patients with sepsis, CAP and skin abscess had higher concentrations of RANTES compared to controls (P = 0.0057, P = 0.0004 and P = 0.0108, respectively). IP-10 values were higher in patients with sepsis compared to children with skin abscess (P = 0.0075). However, MCP-1 levels were lower in septic patients compared to controls (P = 0.0136). There was no difference on MIG concentrations between the groups. Our original findings observed that RANTES was consistently elevated in all types of infections suggesting this chemokine may play an important role in the pathogenesis of bacterial infection. Additionally, patients with sepsis had a unique pattern of response with high levels of IP-10 but low levels of MCP-1, which should be further explored as the markers of disease severity.

Morphological and morphometric study of cercariae and adult worms of Schistosoma mansoni (SLM strain) isolated from infected mice.

In northeastern Brazil, the schistosomiasis is historically endemic and considered as a public health problem. The Schistosoma mansoni São Lourenço da Mata (SLM-PE, Brazil) strain was used in several paper already published; however, morphological and morphometric studies about this strain was never done. In this work, scanning electron microscopy (SEM) was used in morphological and morphometric analysis of cercariae and adult worms. Cercariae were obtained from Biomphalaria glabrata snails and adult worms from mice, both infected by the S. mansoni SLM strain, fixed and prepared for SEM. The results showed that cercariae of S. mansoni measures 254.9 µm of length. The bodies are covered by spines, with a ventral sucker, an oral sucker with sensory receivers, and a pair of penetration glands in the head. The area of tail and body and the distance between suckers were 3,011.77, 1,530.32, and 42.9 µm, respectively. Adult worms of S. mansoni were divided into three main regions: the anterior, medial, and posterior, besides the gynecophoral canal in males. The measure of adult worms of S. mansoni was 4 mm males and 5 mm females. The anterior region length of the male was 470 µm and of the female 271 µm. All the parameters were assayed in ten samples. The morphometric values found in the SLM strain were smaller than other S. mansoni strains described in the literature as well as other helminths. This is the first morphological and morphometric study with the SLM strain of S. mansoni being extremely important for improving control strategies and life quality of the local population.

Abundance and diversity of resistance genes in the sugarcane transcriptome revealed by in silico analysis.

Resistance genes (R-genes) are responsible for the first interaction of the plant with pathogens being responsible for the activation (or not) of the defense response. Despite their importance and abundance, no tools for their automatic annotation are available yet. The present study analyzed R-genes in the sugarcane expressed sequence tags database which includes 26 libraries of different tissues and development stages comprising 237,954 expressed sequence tags. A new annotation routine was used in order to avoid redundancies and overestimation of R-gene number, common mistakes in previous evaluations. After in silico screening, 280 R-genes were identified, with 196 bearing the complete domains expected. Regarding the alignments, most of the sugarcane's clusters yielded best matches with proteins from Oryza sativa, probably due to the prevalence of sequences of this monocot in data banks. All R-gene classes were found except the subclass LRR-NBS-TIR (leucine-rich repeats, nucleotide-binding site, including Toll interleukin-1 receptors), with prevalence of the kinase (Pto-like) class. R-genes were expressed in all libraries, but flowers, transition root to shoot, and roots were the most representative, suggesting that in sugarcane the expression of R-genes in non-induced conditions prevails in these tissues. In leaves, only low level of expression was found for some gene classes, while others were completely absent. A high allelic diversity was found in all classes of R-genes, sometimes showing best alignments with dicotyledons, despite the great number of genes from rice, maize and other grasses deposited in data banks. The results and future possibilities regarding R-genes in sugarcane research and breeding are further discussed.

Abundance and diversity of resistance genes in the sugarcane transcriptome revealed by in silico analysis

Resistance genes (R-genes) are responsible for the first interaction of the plant with pathogens being responsible for the activation (or not) of the defense response. Despite their importance and abundance, no tools for their automatic annotation are available yet. The present study analyzed R-genes in the sugarcane expressed sequence tags database which includes 26 libraries of different tissues and development stages comprising 237,954 expressed sequence tags. A new annotation routine was used in order to avoid redundancies and overestimation of R-gene number, common mistakes in previous evaluations. After in silico screening, 280 R-genes were identified, with 196 bearing the complete domains expected. Regarding the alignments, most of the sugarcane’s clusters yielded best matches with proteins from Oryza sativa, probably due to the prevalence of sequences of this monocot in data banks. All R-gene classes were found except the subclass LRR-NBS-TIR (leucine-rich repeats, nucleotide-binding site, including Toll interleukin-1 receptors), with prevalence of the kinase (Pto-like) class. R-genes were expressed in all libraries, but flowers, transition root to shoot, and roots were the most representative, suggesting that in sugarcane the expression of R-genes in non-induced conditions prevails in these tissues. In leaves, only low level of expression was found for some gene classes, while others were completely absent. A high allelic diversity was found in all classes of R-genes, sometimes showing best alignments with dicotyledons, despite the great number of genes from rice, maize and other grasses deposited in data banks. The results and future possibilities regarding R-genes in sugarcane research and breeding are further discussed.

Sindrome de Cushing cinquenta anos depois. (157 refs.). / Cushing syndrome, 50 years latter

Neste quinquagesimo aniversario do trabalho classico de Harvey Cushing - "The Basophil Adenomas of the Pituitary Body and their Clinical Manifestations(pituitary basophilism)", Bull. Johns Hopk. Hosp. 50:137-95, 1932 -, os autores revisam os principais aspectos desta entidade, assim como das sindromes de Cushing adrenal e ectopica. Particular destaque e conferido a etiopatogenia da sindrome de Cushing hipotalamo-hipofisaria (SCHH) com discussao das hipoteses etiologicas disponiveis. A introducao do novo conceito de displasia nodular primaria (DNP) individualiza melhor e torna mais homogeneo o grupo das hiperplasias macro e micronodulares. As repercussoes do hipercortisolismo endogeno sobre o metabolismo dos carboidritos, lipidos e proteinas e sobre as funcoes organicas sao comentadas, assim como o valor relativo das dosagens hormonais, testes e demais exames laboratoriais, para o diagnostico diferencial das sindromes de Cushing. Finalmente, os autores confrontam os muitos tratamentos, quimioterapicos, radioterapicos e cirurgicos disponiveis para a SCHH e analisam a eficacia, indicacoes, vantagens e inconvenientes de cada um