Comparison of Ultrasound and MRI with Intraoperative Findings in the Diagnosis of Peroneal Tendinopathy, Tears, and Subluxation.

Suspected peroneal tendinopathy, tears, and subluxation are often confirmed preoperatively using magnetic resonance imaging (MRI) or diagnostic ultrasound (US). No study has directly compared the accuracy of these tests for the diagnosis of peroneal tendon pathology. The purpose of this study is to directly compare MRI and US to intraoperative findings in patients who underwent surgery for suspected peroneal pathology to determine the imaging diagnostic accuracy. Operative records and diagnostic images for 21 consecutive patients who had both MRI and US prior to surgery for suspected peroneal tendinopathy, tears, or subluxation were retrospectively reviewed. The results of this review are compared with the intraoperative findings to yield the sensitivity and specificity for each imaging modality. For the diagnosis of peroneal tendon tears, US was found to have a sensitivity of 88% and specificity of 100%, compared to 100% sensitivity and specificity for MRI. In the diagnosis of peroneal tendinopathy, both US and MRI had a sensitivity and specificity of 100%. In diagnosing peroneal subluxation, US was 100% sensitive compared to 66% for MRI, and both were 100% specific. In conclusion, US was found to be more effective in diagnosing peroneal subluxation and MRI was slightly more accurate in the diagnosis of peroneal tendon tears.

Evaluation of the knee joint with ultrasound and magnetic resonance imaging.

The knee joint relies on a combination of deep and superficial structures for stability and function. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these structures and associated pathology. This article reviews a combination of critical anatomic structures, joint abnormalities, and pathologic conditions at the knee joint, while highlighting the merits, limitations, and pitfalls of the two imaging modalities. A clear appreciation of each method paired with its relative strengths will aid in expediting diagnosis and appropriate treatment for a wide range of knee joint conditions.

Ultrasound versus MRI in the evaluation of the thumb metacarpophalangeal joint.

An intricate and unique combination of ligamentous, fibrocartilaginous, and osseous structures stabilize the thumb metacarpophalangeal joint. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these critical structures. This article reviews common injuries of the thumb metacarpophalangeal joint, while highlighting the merits, limitations, and pitfalls of the two imaging modalities. A clear appreciation of each method, paired with anatomic knowledge, will lend greater confidence and accuracy to diagnosing impactful injuries and guiding intervention.

Individuals of a group-living shorebird show smaller home range overlap when food availability is low.

BACKGROUND: Group living animals, such as shorebirds foraging on intertidal mudflats, may use social information about where to find hidden food items. However, flocking also increases intraspecific competition for resources, which may be exacerbated by food scarcity. Therefore, although aggregation may bring benefits, it may also increase the intensity of intraspecific competition. METHODS: We examined this trade-off in adult great knots Calidris tenuirostris, a molluscivorous long-distance migrating shorebird species, using interannual variation based on 2 years with different levels of food availability during their northward migratory staging in the northern Yellow Sea, China. We estimated individual home ranges and the extent of spatial overlap of home ranges of individually tagged birds in 2012 and 2015, whilst discounting for possible differences in body size, body mass, sex and migration schedule between years. RESULTS: We found that home range size was not associated with body mass, arrival date, body size, or sex of the individual. Despite a significant difference in food availability between the two study years, there was no significant change in the 50% and 95% home range size of great knots in the contrasting situations. However, there was a significantly smaller spatial overlap between individuals in the year when food was less available, suggesting that great knots operated more independently when food was scarce than when it was abundant. CONCLUSIONS: These results suggest that minimizing intraspecific competition became more important when food was scarce. Where it is impossible to monitor all habitats en route, monitoring the local movements of shorebirds may offer a way to detect changes in habitat quality in real time.

Effects of anthropogenic landscapes on population maintenance of waterbirds.

Anthropogenic impacts have reduced natural areas but increased the area of anthropogenic landscapes. There is debate about whether anthropogenic landscapes (e.g., farmlands, orchards, and fish ponds) provide alternatives to natural habitat and under what circumstances. We considered whether anthropogenic landscapes can mitigate population declines for waterbirds. We collected data on population trends and biological traits of 1203 populations of 579 species across the planet. Using Bayesian generalized linear mixed models, we tested whether the ability of a species to use an anthropogenic landscape can predict population trends of waterbird globally and of species of conservation concern. Anthropogenic landscapes benefited population maintenance of common but not less-common species. Conversely, the use of anthropogenic landscapes was associated with population declines for threatened species. Our findings delineate some limitations to the ability of anthropogenic landscapes to mitigate population declines, suggesting that the maintenance of global waterbird populations depends on protecting remaining natural areas and improving the habitat quality in anthropogenic landscapes. Article impact statement: Protecting natural areas and improving the quality of anthropogenic landscapes as habitat are both needed to achieve effective conservation.

Efectos de los Paisajes Antropogénicos sobre la Conservación de Poblaciones de Aves Acuáticas Resumen Los impactos antropogénicos han reducido las áreas naturales, pero han incrementado el área de los paisajes antropogénicos. Existe un debate sobre si los paisajes antropogénicos (p. ej.: campos de cultivo, huertos, estanques de peces) proporcionan alternativas al hábitat natural y bajo cuáles circunstancias. Consideramos si los paisajes antropogénicos pueden mitigar las declinaciones poblacionales de las aves acuáticas. Recolectamos datos sobre las tendencias poblacionales y las características biológicas de 1203 poblaciones de 579 especies de aves de todo el mundo. Mediante modelos bayesianos generalizados lineales mixtos, analizamos si la habilidad de una especie para usar un paisaje antropogénico puede pronosticar las tendencias poblacionales de las aves acuáticas a nivel mundial y de las especies de interés para la conservación. Los paisajes antropogénicos beneficiaron a la conservación de las poblaciones de especies comunes, pero no para las especies menos comunes. Por otro lado, el uso de paisajes antropogénicos estuvo asociado con las declinaciones poblacionales en las especies amenazadas. Nuestros descubrimientos delinean algunas limitaciones que tienen los paisajes antropogénicos para mitigar las declinaciones poblacionales, lo que sugiere que la conservación mundial de las poblaciones de aves acuáticas depende de la protección de las áreas naturales remanentes y del mejoramiento de la calidad del hábitat en los paisajes antropogénicos.

Dual threat of tidal flat loss and invasive Spartina alterniflora endanger important shorebird habitat in coastal mainland China.

China's coastal wetlands are critically important to shorebirds. Substantial loss of tidal flats, shorebirds' primary foraging grounds, has occurred from land claim and other processes, and is driving population declines in multiple species. Smooth cordgrass Spartina alterniflora was intentionally introduced to the coast of China in 1979 to promote conversion of tidal flats into dry land and has since spread rapidly. The occurrence of S. alterniflora reduces the availability of foraging and roosting habitat for shorebirds, and may be particularly detrimental in places that have experienced other tidal flat loss. However, the extent to which S. alterniflora is encroaching upon important shorebird habitat throughout coastal mainland China, and its intersection with tidal flat loss, has not been quantified. Here, we i) estimate change in the spatial extent of tidal flats between 2000 and 2015 in coastal mainland China where internationally important numbers of shorebirds have been recorded; ii) map the extent of S. alterniflora coverage in 2015 at the same set of sites; and, iii) investigate where these two threats to important shorebird habitat intersect. Our analysis of remote sensing data indicated a 15% net loss in tidal flat area between 2000 and 2015 across all sites, including a net loss in tidal flat area in 39 of 53 individual sites (74%). Spartina alterniflora occurred at 28 of 53 sites (53%) in 2015, of which 22 sites (79%) also had a net loss in tidal flat area between 2000 and 2015. Combined pressures from tidal flat loss and S. alterniflora invasion were most severe in eastern coastal China. Species highly dependent on migrating through this region, which include the Critically Endangered Spoon-billed Sandpiper and Endangered Nordmann's Greenshank and Far Eastern Curlew, may be particularly impacted. Our results underscore the urgent need to arrest tidal flat declines and develop a comprehensive control program for S. alterniflora in coastal areas of mainland China that are important for shorebirds.

Small sequence variations between two mammalian paralogs of the small GTPase SAR1 underlie functional differences in coat protein complex II assembly.

Vesicles that are coated by coat protein complex II (COPII) are the primary mediators of vesicular traffic from the endoplasmic reticulum to the Golgi apparatus. Secretion-associated Ras-related GTPase 1 (SAR1) is a small GTPase that is part of COPII and, upon GTP binding, recruits the other COPII proteins to the endoplasmic reticulum membrane. Mammals have two SAR1 paralogs that genetic data suggest may have distinct physiological roles, e.g. in lipoprotein secretion in the case of SAR1B. Here we identified two amino acid clusters that have conserved SAR1 paralog-specific sequences. We observed that one cluster is adjacent to the SAR1 GTP-binding pocket and alters the kinetics of GTP exchange. The other cluster is adjacent to the binding site for two COPII components, SEC31 homolog A COPII coat complex component (SEC31) and SEC23. We found that the latter cluster confers to SAR1B a binding preference for SEC23A that is stronger than that of SAR1A for SEC23A. Unlike SAR1B, SAR1A was prone to oligomerize on a membrane surface. SAR1B knockdown caused loss of lipoprotein secretion, overexpression of SAR1B but not of SAR1A could restore secretion, and a divergent cluster adjacent to the SEC31/SEC23-binding site was critical for this SAR1B function. These results highlight that small primary sequence differences between the two mammalian SAR1 paralogs lead to pronounced biochemical differences that significantly affect COPII assembly and identify a specific function for SAR1B in lipoprotein secretion, providing insights into the mechanisms of large cargo secretion that may be relevant for COPII-related diseases.

Phenome-based approach identifies RIC1-linked Mendelian syndrome through zebrafish models, biobank associations and clinical studies.

Discovery of genotype-phenotype relationships remains a major challenge in clinical medicine. Here, we combined three sources of phenotypic data to uncover a new mechanism for rare and common diseases resulting from collagen secretion deficits. Using a zebrafish genetic screen, we identified the ric1 gene as being essential for skeletal biology. Using a gene-based phenome-wide association study (PheWAS) in the EHR-linked BioVU biobank, we show that reduced genetically determined expression of RIC1 is associated with musculoskeletal and dental conditions. Whole-exome sequencing identified individuals homozygous-by-descent for a rare variant in RIC1 and, through a guided clinical re-evaluation, it was discovered that they share signs with the BioVU-associated phenome. We named this new Mendelian syndrome CATIFA (cleft lip, cataract, tooth abnormality, intellectual disability, facial dysmorphism, attention-deficit hyperactivity disorder) and revealed further disease mechanisms. This gene-based, PheWAS-guided approach can accelerate the discovery of clinically relevant disease phenome and associated biological mechanisms.

Morphological and digestive adjustments buffer performance: How staging shorebirds cope with severe food declines.

Organisms cope with environmental stressors by behavioral, morphological, and physiological adjustments. Documentation of such adjustments in the wild provides information on the response space in nature and the extent to which behavioral and bodily adjustments lead to appropriate performance effects. Here we studied the morphological and digestive adjustments in a staging population of migrating Great Knots Calidris tenuirostris in response to stark declines in food abundance and quality at the Yalu Jiang estuarine wetland (northern Yellow Sea, China). At Yalu Jiang, from 2011 to 2017 the densities of intertidal mollusks, the food of Great Knots, declined 15-fold. The staple prey of Great Knots shifted from the relatively soft-shelled bivalve Potamocorbula laevis in 2011-2012 to harder-shelled mollusks such as the gastropod Umbonium thomasi in 2016-2017. The crushing of the mollusks in the gizzard would require a threefold to 11-fold increase in break force. This was partially resolved by a 15% increase in gizzard mass which would yield a 32% increase in shell processing capacity. The consumption of harder-shelled mollusks was also accompanied by reliance on regurgitates to excrete unbreakable parts of prey, rather than the usual intestinal voidance of shell fragments as feces. Despite the changes in digestive morphology and strategy, there was still an 85% reduction in intake rate in 2016-2017 compared with 2011-2012. With these morphological and digestive adjustments, the Great Knots remaining faithful to the staging site to a certain extent buffered the disadvantageous effects of dramatic food declines. However, compensation was not complete. Locally, birds will have had to extend foraging time and use a greater daily foraging range. This study offers a perspective on how individual animals may mitigate the effects of environmental change by morphological and digestive strategies and the limits to the response space of long-distance migrating shorebirds in the wild.

Multiple habitat use by declining migratory birds necessitates joined-up conservation.

Many species depend on multiple habitats at different points in space and time. Their effective conservation requires an understanding of how and when each habitat is used, coupled with adequate protection. Migratory shorebirds use intertidal and supratidal wetlands, both of which are affected by coastal landscape change. Yet the extent to which shorebirds use artificial supratidal habitats, particularly at highly developed stopover sites, remains poorly understood leading to potential deficiencies in habitat management. We surveyed shorebirds on their southward migration in southern Jiangsu, a critical stopover region in the East Asian Australasian Flyway (EAAF), to measure their use of artificial supratidal habitats and assess linkages between intertidal and supratidal habitat use. To inform management, we examined how biophysical features influenced occupancy of supratidal habitats, and whether these habitats were used for roosting or foraging. We found that shorebirds at four of five sites were limited to artificial supratidal habitats at high tide for ~11-25 days per month because natural intertidal flats were completely covered by seawater. Within the supratidal landscape, at least 37 shorebird species aggregated on artificial wetlands, and shorebirds were more abundant on larger ponds with less water cover, less vegetation, at least one unvegetated bund, and fewer built structures nearby. Artificial supratidal habitats were rarely used for foraging and rarely occupied when intertidal flats were available, underscoring the complementarity between supratidal roosting habitat and intertidal foraging habitat. Joined-up artificial supratidal management and natural intertidal habitat conservation are clearly required at our study site given the simultaneous dependence by over 35,000 migrating shorebirds on both habitats. Guided by observed patterns of habitat use, there is a clear opportunity to improve habitat condition by working with local land custodians to consider shorebird habitat requirements when managing supratidal ponds. This approach is likely applicable to shorebird sites throughout the EAAF.

Changes in area and number of nature reserves in China.

Nature reserves (NR) are the cornerstone of biodiversity conservation. Over the past 60 years, the rapid expansion of NRs in China, one of the world's megadiverse countries, has played a critical role in slowing biodiversity loss. We examined the changes in the number and area of China's NRs from 1956 to 2014 and analyzed the effect of economic development on the expansion of China's NRs from 2005 to 2014 with linear models. Despite a continuing increase in the number of NRs, the total area of China's NRs decreased by 3% from 2007 to 2014. This loss resulted from downsizing and degazettement of existing NRs and a slowdown in the establishment of new ones. Nature reserves in regions with rapid economic development exhibited a greater decrease in area, suggesting that downsizing and degazettement of NRs are closely related to the intensifying competition between economic growth and conservation. For example, boundary adjustments to national NRs, the most strictly protected NRs, along the coast of China's Yellow Sea, a global biodiversity hotspot with a fast-growing economy, resulted in the loss of one-third of the total area. One of the most important ecosystems in these NRs, tidal wetlands, decreased by 27.8% because of boundary adjustments and by 25.2% because of land reclamation. Our results suggest conservation achievement, in terms of both area and quality, are declining at least in some regions in the Chinese NR estate. Although the designation of protected areas that are primarily managed for sustainable use has increased rapidly in recent years in China, we propose that NRs with biodiversity conservation as their main function should not be replaced or weakened.

Cambios en la Superficie y el Número de Reservas Naturales en China Resumen Las reservas naturales (RN) son la piedra angular de la conservación de la biodiversidad. Durante los últimos 60 años, la rápida expansión de las RN en China, uno de los países megadiversos, ha jugado un papel crítico en la reducción de la pérdida de biodiversidad. Examinamos los cambios en el número y superficie de las RN en China de 1956 a 2014 y analizamos el efecto del desarrollo económico en la expansión de las RN en China de 2005 a 2014 mediante modelos lineales. A pesar del incremento continuo en el número de RN, la superficie total de RN en China decreció en 3% de 2007 a 2014. Esta pérdida resultó de la reducción y cambio de registro de RN existentes y una desaceleración en el establecimiento de RN nuevas. Las reservas naturales en regiones con desarrollo económico rápido presentaron una mayor disminución en la superficie, lo que sugiere que la reducción y cambio de registro de RN están relacionados cercanamente con la intensificación de la competencia entre crecimiento económico y conservación. Por ejemplo, ajustes en los límites de RN nacionales, las RN más estrictamente protegidas, a lo largo de la costa del Mar Amarillo, un sitio de importancia para la biodiversidad global con una economía en rápido crecimiento, resultó en la pérdida de un tercio de la superficie total. Uno de los ecosistemas más importantes en estas RN, humedales mareales, decreció en 27.8% debido a ajustes en los límites y en 25.2% debido a la reclamación de tierras. Nuestros resultados sugieren que los logros de conservación, en términos tanto de área como de calidad, están declinando en las RN de China. Aunque la designación de áreas protegidas administradas primariamente para un uso sustentable ha incrementado rápidamente en años recientes en China, proponemos que las RN cuya principal función es la conservación de la biodiversidad no deben ser reemplazadas o debilitadas.

Fatty-acid binding protein 5 modulates the SAR1 GTPase cycle and enhances budding of large COPII cargoes.

COPII-coated vesicles are the primary mediators of ER-to-Golgi trafficking. Sar1, one of the five core COPII components, is a highly conserved small GTPase, which, upon GTP binding, recruits the other COPII proteins to the ER membrane. It has been hypothesized that the changes in the kinetics of SAR1 GTPase may allow for the secretion of large cargoes. Here we developed a cell-free assay to recapitulate COPII-dependent budding of large lipoprotein cargoes from the ER. We identified fatty-acid binding protein 5 (FABP5) as an enhancer of this budding process. We found that FABP5 promotes the budding of particles ∼150 nm in diameter and modulates the kinetics of the SAR1 GTPase cycle. We further found that FABP5 enhances the trafficking of lipoproteins and of other cargoes, including collagen. These data identify a novel regulator of SAR1 GTPase activity and highlight the importance of this activity for trafficking of large cargoes.

The nutritional nexus: Linking niche, habitat variability and prey composition in a generalist marine predator.

Our understanding of the niche concept will remain limited while the quantity and range of different food types eaten remain a dominant proxy for niche breadth, as this does not account for the broad ecological context that governs diet. Linking nutrition, physiology and behaviour is critical to predict the extent to which a species adjusts its nutritional niche breadth at the levels of prey ("prey composition niche," defined as the range of prey compositions eaten) and diet ("realized nutritional niche" is the range of diets composed through feeding on the prey). Here, we studied adult chick-rearing Australasian gannets Morus serrator to propose an integrative approach using sea surface temperature anomalies (SSTa), geographic location and bathymetry over different years, to explore their relationship with the nutritional composition of prey and diets (i.e. prey composition and nutritional niche breadth), habitat use and foraging behaviour. We found that gannets feed on prey that varied widely in their nutritional composition (have a broad prey composition niche), and composed diets from these prey that likewise varied in composition (have a broad realized nutritional niche), suggesting generalism at two levels of macronutrient selection. Across seasons, we established "nutritional landscapes" (hereafter nutriscapes), linking the nutritional content of prey (wet mass protein-to-lipid ratio-P:L) to the most likely geographic area of capture and bathymetry. Nutriscapes varied in their P:L from 6.06 to 15.28, over time, space and bathymetry (0-150 m). During warm water events (strong positive SSTa), gannets expanded their foraging habitat, increased their foraging trip duration and consumed prey and diets with low macronutrient content (wet mass proportions of P and L). They were also constrained to the smallest prey composition and realized nutritional niche breadths. Our findings are consistent with previous suggestions that dietary generalism evolves in heterogeneous environments, and provide a framework for understanding the nutritional goals in wild marine predators and how these goals drive ecological interactions and are, in turn, ultimately shaped by environmental fluctuations.

The ULK1-FBXW5-SEC23B nexus controls autophagy.

In response to nutrient deprivation, the cell mobilizes an extensive amount of membrane to form and grow the autophagosome, allowing the progression of autophagy. By providing membranes and stimulating LC3 lipidation, COPII (Coat Protein Complex II) promotes autophagosome biogenesis. Here, we show that the F-box protein FBXW5 targets SEC23B, a component of COPII, for proteasomal degradation and that this event limits the autophagic flux in the presence of nutrients. In response to starvation, ULK1 phosphorylates SEC23B on Serine 186, preventing the interaction of SEC23B with FBXW5 and, therefore, inhibiting SEC23B degradation. Phosphorylated and stabilized SEC23B associates with SEC24A and SEC24B, but not SEC24C and SEC24D, and they re-localize to the ER-Golgi intermediate compartment, promoting autophagic flux. We propose that, in the presence of nutrients, FBXW5 limits COPII-mediated autophagosome biogenesis. Inhibition of this event by ULK1 ensures efficient execution of the autophagic cascade in response to nutrient starvation.

Speciation, range contraction and extinction in the endemic New Zealand King Shag complex.

New Zealand's endemic King Shag (Leucocarbo carunculatus) has occupied only a narrow portion of the northeastern South Island for at least the past 240years. However, pre-human Holocene fossil and archaeological remains have suggested a far more widespread distribution of the three Leucocarbo species (King, Otago, Foveaux) on mainland New Zealand at the time of Polynesian settlement in the late 13th Century CE. We use modern and ancient DNA, and morphometric and osteological analyses, of modern King Shags and Holocene fossil Leucocarbo remains to assess the pre-human distribution and taxonomic status of the King Shag on mainland New Zealand, and the resultant conservation implications. Our analyses show that the King Shag was formerly widespread around southern coasts of the North Island and the northern parts of the South Island but experienced population and lineage extinctions, and range contraction, probably after Polynesian arrival. This history parallels range contractions of other New Zealand seabirds. Conservation management of the King Shag should take into account this species narrow distribution and probable reduced genetic diversity. Moreover, combined genetic, morphometric and osteological analyses of prehistoric material from mainland New Zealand suggest that the now extinct northern New Zealand Leucocarbo populations comprised a unique lineage. Although these distinctive populations were previously assigned to the King Shag (based on morphological similarities and geographic proximity to modern Leucocarbo populations), we herein describe them as a new species, the Kohatu Shag (Leucocarbo septentrionalis). The extinction of this species further highlights the dramatic impacts Polynesians and introduced predators had on New Zealand's coastal and marine biodiversity. The prehistoric presence of at least four species of Leucocarbo shag on mainland NZ further highlights its status as a biodiversity hotspot for Phalacrocoracidae.

Shear-Wave Elastography: Basic Physics and Musculoskeletal Applications.

In the past 2 decades, sonoelastography has been progressively used as a tool to help evaluate soft-tissue elasticity and add to information obtained with conventional gray-scale and Doppler ultrasonographic techniques. Recently introduced on clinical scanners, shear-wave elastography (SWE) is considered to be more objective, quantitative, and reproducible than compression sonoelastography with increasing applications to the musculoskeletal system. SWE uses an acoustic radiation force pulse sequence to generate shear waves, which propagate perpendicular to the ultrasound beam, causing transient displacements. The distribution of shear-wave velocities at each pixel is directly related to the shear modulus, an absolute measure of the tissue's elastic properties. Shear-wave images are automatically coregistered with standard B-mode images to provide quantitative color elastograms with anatomic specificity. Shear waves propagate faster through stiffer contracted tissue, as well as along the long axis of tendon and muscle. SWE has a promising role in determining the severity of disease and treatment follow-up of various musculoskeletal tissues including tendons, muscles, nerves, and ligaments. This article describes the basic ultrasound physics of SWE and its applications in the evaluation of various traumatic and pathologic conditions of the musculoskeletal system. ©RSNA, 2017.

Rapid population decline in migratory shorebirds relying on Yellow Sea tidal mudflats as stopover sites.

Migratory animals are threatened by human-induced global change. However, little is known about how stopover habitat, essential for refuelling during migration, affects the population dynamics of migratory species. Using 20 years of continent-wide citizen science data, we assess population trends of ten shorebird taxa that refuel on Yellow Sea tidal mudflats, a threatened ecosystem that has shrunk by >65% in recent decades. Seven of the taxa declined at rates of up to 8% per year. Taxa with the greatest reliance on the Yellow Sea as a stopover site showed the greatest declines, whereas those that stop primarily in other regions had slowly declining or stable populations. Decline rate was unaffected by shared evolutionary history among taxa and was not predicted by migration distance, breeding range size, non-breeding location, generation time or body size. These results suggest that changes in stopover habitat can severely limit migratory populations.

TANGO1 assembles into rings around COPII coats at ER exit sites.

TANGO1 (transport and Golgi organization 1) interacts with CTAGE5 and COPII components Sec23/Sec24 and recruits ERGIC-53 (endoplasmic reticulum [ER]-Golgi intermediate compartment 53)-containing membranes to generate a mega-transport carrier for export of collagens and apolipoproteins from the ER. We now show that TANGO1, at the ER, assembles in a ring that encircles COPII components. The C-terminal, proline-rich domains of TANGO1 molecules in the ring are initially tilted onto COPII coats but appear to be pushed apart as the carrier grows. These findings lend support to our suggestion that growth of transport carriers for exporting bulky cargoes requires addition of membranes and not simply COPII-mediated accretion of a larger surface of ER. TANGO1 remains at the neck of the newly forming transport carrier, which grows in size by addition of ERGIC-53-containing membranes to generate a transport intermediate for the export of bulky collagens.

Ultrasound Evaluation of Morton Neuroma Before and After Laser Therapy.

OBJECTIVE: The objective of our study was to retrospectively assess for differences in imaging appearances of Morton neuromas before and after laser therapy using diagnostic ultrasound (US). MATERIALS AND METHODS: A retrospective review was performed to identify patients who underwent US imaging to evaluate for Morton neuroma during the study period (June 1, 2013-July 1, 2014); of the 42 patients identified, 21 underwent US evaluations before and after laser therapy. US reports and images were reviewed and correlated with clinical history. The final study group consisted of 21 patients who had a total of 31 Morton neuromas evaluated using US after treatment. A retrospective review was then performed to characterize the appearances of these lesions before and after therapy followed by an analysis of variables. RESULTS: Retrospective US review of 31 pretreatment Morton neuromas showed fusiform, heterogeneously hypoechoic masses with well-defined borders in most cases and that pain was reported when transducer pressure was applied in 97% (30/31) of cases. After treatment, lesions showed ill-defined borders (23/31), and pain with application of transducer pressure was either significantly decreased or absent (29/31); these findings were concordant with the clinical findings. Both of these characteristics were statistically significant (p < 0.0001). In addition, more Morton neuromas occurred in the second intermetatarsal space than in the third intermetatarsal space (p < 0.0001). CONCLUSION: US may be used to identify posttreatment changes after laser therapy of Morton neuromas. Posttreatment changes include ill-defined borders and less pain or the absence of pain with the application of transducer pressure. These criteria may be applied in future clinical studies evaluating the efficacy of laser therapy for Morton neuroma.

Normal Magnetic Resonance Imaging Anatomy of the Capsular Ligamentous Supporting Structures of the Knee.

Recognition of the normal magnetic resonance (MR) imaging appearances of the capsular ligaments of the knee is of great importance. These ligaments contribute to stability of the knee joint and are frequently injured. In this article, we describe the normal MR imaging anatomy of the capsular ligaments of the knee including the lateral and medial collateral ligamentous complexes, the extensor mechanism, and the supporting ligamentous structures of the proximal tibiofibular joint. Normal MR imaging findings and important anatomic variants of the neurovascular structures of the knee are also described.