Orthopedic management of decubitus ulcers around the proximal femur.

Decubitus ulcers, commonly known as pressure ulcers or sores, represent localized areas of tissue necrosis. Despite increased awareness and use of preventive measures, these ulcers remain a major concern in the hospitalized and immobile patient population. When the hip joint becomes infected or the wound remains refractory to nonsurgical treatments, the orthopedic surgeon becomes involved in patient care. In this review, a brief overview of decubitus ulcers and their nonsurgical management is given, followed by a discussion of various flaps used in more extensive repairs. The major orthopedic procedures presented include proximal femoral resection (Girdlestone procedure), hip disarticulation, and hemipelvectomy. These surgeries retain an important position in managing complicated decubitus ulcers around the proximal femur.

The yeast genes, ARL1 and CCZ1, interact to control membrane traffic and ion homeostasis.

The yeast ARL1 gene, encoding a guanine-nucleotide binding protein of the Arf-like family, exhibits a synthetic genetic interaction with CCZ1. An arl1 Delta ccz1 Delta double mutant was viable but grew slowly, was more sensitive to caffeine, Ca(2+), Zn(2+), and hygromycin B than either single mutant, and had a more severe vacuolar protein sorting phenotype. Overexpression of ARL1 did not suppress ccz1 Delta mutant phenotypes, nor did overexpression of CCZ1 suppress arl1 Delta mutant phenotypes. We conclude that ARL1 and CCZ1 independently contribute to both ion homeostasis and protein sorting.