Airborne signals of Pseudomonas fluorescens modulate swimming motility and biofilm formation of Listeria monocytogenes in a contactless coculture system.

Bacterial volatile compounds (BVCs) facilitate interspecies communication in socio-microbiology across physical barriers, thereby influencing interactions between diverse species. The impact of BVCs emitted from Pseudomonas on the biofilm formation characteristics of Listeria monocytogenes within the same ecological niche has been scarcely investigated under practical conditions of food processing. The objective of this study was to explore the motility and biofilm formation characteristics of L. monocytogenes under the impact of Pseudomonas BVCs. It was revealed that BVCs of P. fluorescens, P. lundensis, and P. fragi significantly promoted swimming motility of L. monocytogenes (P < 0.05). As evidenced by crystal violet staining, the L. monocytogenes biofilms reached a maximum OD570 value of approximately 3.78 at 4 d, which was 0.65 units markedly higher than that of the control group (P < 0.05). Despite a decrease in adherent cells of L. monocytogenes biofilms among the BVCs groups, there was a remarkable increase in the abundance of extracellular polysaccharides and proteins with 3.58 and 4.90 µg/cm2, respectively (P < 0.05), contributing to more compact matrix architectures, which suggested that the BVCs of P. fluorescens enhanced L. monocytogenes biofilm formation through promoting the secretion of extracellular polymers. Moreover, the prominent up-regulated expression of virulence genes further revealed the positive regulation of L. monocytogenes under the influence of BVCs. Additionally, the presence of BVCs significantly elevated the pH and TVB-N levels in both the swimming medium and biofilm broth, thereby exhibiting a strong positive correlation with increased motility and biofilm formation of L. monocytogenes. It highlighted the crucial signaling regulatory role of BVCs in bacterial interactions, while also emphasizing the potential food safety risk associated with the hitchhiking behavior of L. monocytogenes, thereby shedding light on advancements in control strategies for food processing.

The role of PhoP/PhoQ system in regulating stress adaptation response in Escherichia coli O157:H7.

The development of acid tolerance response (ATR) as a result of low pH in Escherichia coli O157:H7 (E. coli O157:H7) contaminating beef during processing is considered a major food safety concern. Thus, in order to explore the formation and molecular mechanisms of the tolerance response of E. coli O157:H7 in a simulated beef processing environment, the resistance of a wild-type (WT) strain and its corresponding ΔphoP mutant to acid, heat, and osmotic pressure was evaluated. Strains were pre-adapted under different conditions of pH (5.4 and 7.0), temperature (37 °C and 10 °C), and culture medium (meat extract and Luria-Bertani broth media). In addition, the expression of genes related to stress response and virulence was also investigated among WT and ΔphoP strains under the tested conditions. Pre-acid adaptation increased the resistance of E. coli O157:H7 to acid and heat treatment while resistance to osmotic pressure decreased. Moreover, acid adaptation in meat extract medium simulating slaughter environment increased ATR, whereas pre-adaptation at 10 °C reduced the ATR. Furthermore, it was shown that mildly acidic conditions (pH = 5.4) and the PhoP/PhoQ two-component system (TCS) acted synergistically to enhance acid and heat tolerance in E. coli O157:H7. Additionally, the expression of genes related to arginine and lysine metabolism, heat shock, and invasiveness was up-regulated, which revealed that the mechanism of acid resistance and cross-protection under mildly acidic conditions was mediated by the PhoP/PhoQ TCS. Both acid adaptation and phoP gene knockout reduced the relative expression of stx1 and stx2 genes which were considered as critical pathogenic factors. Collectively, the current findings indicated that ATR could occur in E. coli O157:H7 during beef processing. Thus, there is an increased food safety risk due to the persistence of tolerance response in the following processing conditions. The present study provides a more comprehensive basis for the effective application of hurdle technology in beef processing.

Potential inhibitory effect of carbon dioxide on the spoilage behaviors of Pseudomonas fragi in high-oxygen packaged beef during refrigerated storage.

Pseudomonas fragi is a dominant meat spoilage organism under high-oxygen modified atmosphere packaging (HiOx-MAP). This work investigated the effects of CO2 on P. fragi growth and the related spoilage phenomena of HiOx-MAP beef. Minced beef incubated with P. fragi T1, a strain owning the strongest spoilage potential among isolates, was stored under CO2-enriched HiOx-MAP (TMAP; 50% O2/40% CO2/10% N2) or non-CO2 HiOx-MAP (CMAP; 50% O2/50% N2) at 4 °C for 14 days. Compared to CMAP, TMAP maintained sufficient O2 levels to endow beef with higher a* values and meat color stability due to lower P. fragi counts from day 1 (P < 0.05). TMAP samples also showed lower (P < 0.05) lipase activity and protease activity within 14-days and 6-days than CMAP samples respectively. TMAP delayed the significantly increased pH and total volatile basic nitrogen contents occurred in CMAP beef during storage. Despite TMAP markedly promoted the lipid oxidation associated with higher concentrations of hexanal and 2,3-octanedione than CMAP (P < 0.05), TMAP beef retained an acceptable organoleptic odor due to a CO2-inhibition on the microbial-induced 2,3-butanedione and ethyl 2-butenoate formation. This study provided a comprehensive insight into the antibacterial mechanism of CO2 on P. fragi in HiOx-MAP beef.

Processing interventions for enhanced microbiological safety of beef carcasses and beef products: A review.

Chilled beef is inevitably contaminated with microorganisms, starting from the very beginning of the slaughter line. A lot of studies have aimed to improve meat safety and extend the shelf life of chilled beef, of which some have focused on improving the decontamination effects using traditional decontamination interventions, and others have investigated newer technologies and methods, that offer greater energy efficiency, lower environmental impacts, and better assurances for the decontamination of beef carcasses and cuts. To inform industry, there is an urgent need to review these interventions, analyze the merits and demerits of each technology, and provide insight into 'best practice' to preserve microbial safety and beef quality. In this review, the strategies and procedures used to inhibit the growth of microorganisms on beef, from slaughter to storage, have been critiqued. Critical aspects, where there is a lack of data, have been highlighted to help guide future research. It is also acknowledge that different intervention programs for microbiological safety have different applications, dependent on the initial microbial load, the type of infrastructures, and different stages of beef processing.

The acid tolerance responses of the Salmonella strains isolated from beef processing plants.

The development of the stationary-phase, low-pH-inducible acid tolerance response (ATR) in the Salmonella contaminant of beef during the processing arises food safety concerns, because it may evoke bacterial coping mechanisms against bactericidal insults and alter gene expression that contribute to pathogen virulence. However, information on the development of the ATR and the stability (defined as the capacity to maintain the acquired acid tolerance after induction) in the Salmonella during the production and distribution of beef is limited. After adaptation overnight, ATRs in the 79 strains of Salmonella isolated from beef processing plants were investigated by comparing the log reduction in the 2-h acid challenge trials at pH 3.0. Six representative strains were selected to further estimate the effect of three factors in the incubation period on the development of the ATR, including adapted pH values (5.0, 5.4, 6.0, and 7.0), temperatures (10 °C and 37 °C), and the adaptation media (meat extract and brain heart infusion media). The stability of acid tolerance during the long-time chilled storage (4 °C for 13 days) was also observed on two strains of serotypes S. Derby and S. Meleagridis. All the strains isolated from beef processing plants exhibited an enhanced acid tolerance indicating the widespread existence of ATR. The results also revealed that strain variability was present in the development of ATR. Significant tolerance to lethal acidic environments (pH 3.0) was found when the Salmonella strains had been acid-adapted in meat extract at pH 5.0, pH 5.4, or pH 6.0, which indicated the possible induction of ATR during beef production. After the acid adaptations, the population reduction after the acid challenge (BHI, pH = 3) in the strains was significantly lower than the non-induced at the 1d, 7 day and 13 day's storage in meat extract media at 4 °C, which revealed the persistence of ATR during beef distribution. Compared to 37 °C, adaptation in lower temperature (10 °C) significantly reduced the ATR and no ATR was developed when adapted in 4 °C. This emphasizes the importance of keeping a low temperature of beef throughout the supply chains of beef industry.

Stem Cell Therapy for Thyroid Diseases: Progress and Challenges.

Background: Thyroid hormones are indispensable for organ development and maintaining homeostasis. Thyroid diseases, including thyroiditis and thyroid cancer, affect the normal secretion of hormones and result in thyroid dysfunction. Objective: This review focuses on therapeutic applications of stem cells for thyroid diseases. Methods: A literature search of Medline and PubMed was conducted (January 2000-July 2021) to identify recent reports on stem cell therapy for thyroid diseases. Results: Stem cells are partially developed cell types. They have the capacity to form specialized cells. Besides embryonic stem cells and mesenchymal stem cells, organ resident stem cells and cancer stem cells are recently reported to have important roles in forming organ specific cells and cancers. Stem cells, especially mesenchymal stem cells, have anti-inflammatory and anticancer functions as well. Conclusions: This review outlines the therapeutic potency of embryonic stem cells, mesenchymal stem cells, thyroid resident stem cells, and thyroid cancer stem cells in thyroid cells' regeneration, thyroid function modulation, thyroiditis suppression, and antithyroid cancers. Stem cells represent a promising form of treatment for thyroid disorders.

Acid tolerance response of Salmonella during simulated chilled beef storage and its regulatory mechanism based on the PhoP/Q system.

To investigate the persistence of acid tolerance response (ATR) and the regulatory mechanism during chilled storage, Salmonella ATCC 14028 and the △phoP mutant were acid adapted and then incubated in meat extract at 4 °C for 24 days as simulated beef storage. The bacterial population, D values and expression of PhoP/PhoQ linked genes of both strains were determined at 6-day intervals. Although a mild suppression effect on the D values of adapted Salmonella was found during the long-time storage in meat extract at 4 °C, the D value of adapted strains was significantly higher than non-adapted strains, indicating the persistence of ATR during the whole aging and distribution of beef posing a threat to food safety. The fact that low temperature inhibits the formation of ATR at the early adapted stage emphasizes the importance of keeping a low-temperature environment during slaughter. An interaction between the acidic adaptation and phoP gene on D values was found and the expression levels of adiA, adiY, cadA and cadB genes was significantly reduced in the △phoP mutant, suggesting that PhoP/Q system plays an important role in the ATR by sensing the pH and regulating lysine and arginine decarboxylation directly or indirectly.

Lactic Acid and Peroxyacetic Acid Inhibit Biofilm of Escherichia coli O157:H7 Formed in Beef Extract.

The objective of this study was to evaluate the inhibitory effect of lactic acid (LA) and peroxyacetic acid (PAA) on the biofilm formation of Escherichia coli O157:H7 in beef extract (BE). BE medium was used as the growth substrate in this study, to make the control effect closer to the situation of the factory. The biofilm inhibitory efficacy of LA and PAA was tested by using a crystal violet staining assay and microscopic examination. And then, extracellular polymeric substance (EPS) production, metabolic activity, and real-time polymerase chain reaction assay were used to reveal the biofilm inhibition mechanism of LA and PAA. The results showed that both LA and PAA significantly inhibited biofilm formation of E. coli O157:H7 at minimum inhibitory concentrations (MICs) (p < 0.05). At MIC, LA and PAA showed different effects on the biofilm metabolic activity and the EPS production of E. coli O157:H7. Supporting these findings, expression analysis showed that LA significantly suppressed quorum sensing genes (luxS and sdiA) and adhesion genes (flhC), while PAA downregulated the transcription of extracellular polysaccharide synthesis genes (adrB and adrA) and the global regulatory factor csgD. This result revealed that LA and PAA had different biofilm inhibitory mechanisms on E. coli O157:H7; LA inhibited the biofilm formation mainly by inhibiting metabolic activity, while PAA inhibited EPS production. This study provided a theoretical basis for the control of E. coli O157:H7 biofilm in the actual production process.

The steps and key points of thyroid surgery with lateral cervical incision.

The thyroid surgery with lateral cervical incision uses the sternocleidomastoid intermuscular approach through the gap between band muscles and carotid sheath to reach the surgical field. The recurrent laryngeal nerve and upper and lower parathyroid glands are first identified, the upper pole vessels are severed; then the Berry ligament is separated; the isthmus is severed, and the thyroid gland is finally removed. This approach can avoid the trauma of the skin and muscle tissue in the anterior neck region, to relieve the pressure on the neck and swallowing stretch feeling for patients after surgery. The surgical modality is effective and less time-consuming. This article gives a detailed introduction to the standardized procedures and some key points of thyroid surgery with lateral cervical incision.

An early-postmortem metabolic comparison among three extreme acute heat stress temperature settings in chicken breast muscle.

Normally, preslaughter acute heat stress could accelerate postmortem glycolysis and impair chicken breast (pectoralis major muscle) quality. However, previous studies indicated that it might be different when the acute heat stress temperature rises to an extreme range (above 35 °C). Therefore, this study's objectives were to compare the pH decline, glycolytic enzyme activity, and AMP-activated protein kinase (AMPK) phosphorylation at early postmortem among three extreme acute heat stress temperature settings: a control group (36 °C) and two experimental groups (38 °C and 40 °C). Although the temperature did not affect glycogen phosphorylase a and pyruvate kinase activity, there was a decrease in pH decline rate, phosphofructokinase-1 activity, and phospho-AMPK-α[Thr172] within 4 h postmortem when temperature increased from 36 to 40 °C. Temperature also affected hexokinase activity, with the 36 °C-group having the highest activity. The results of the current study, for the first time, indicated that postmortem metabolic rate in chicken breast muscle could be changed by acute heat stress temperature setting at extreme range.

Acid Tolerance Response of Listeria monocytogenes in Various External pHs with Different Concentrations of Lactic Acid.

This study evaluated the acid tolerance response (ATR) of two strains of Listeria monocytogenes (serotype 1/2a and 4b) and one strain of Listeria innocua under different mildly acid conditions. Cells were incubated in combinations of three concentrations of lactic acid medium (3, 4.75, and 15 mM) and three external pH's (pHex 5.0, 6.0, and 6.5), plus, a HCl control, and a blank control (pH 7.4). Results showed that lactic acid induced lower log reduction of all three strains when challenged in severe acid conditions (pH 3.0) after being habituated at a pHex of 5.5 or 6.0 until the log phase, compared with a pHex of 6.5 or the two controls. This indicates that when the pHex was either 5.5 or 6.0 this induced a higher ATR of the strains, which may be caused by the ability of the strains to retain intracellular pH (pHi) homeostasis with pHi maintained in the range of 7.4-7.9. It was also found that a pHex of 5.5 resulted in the highest pHi of the strains across all incubated conditions, which indicates that the pHi may play an important role in the induction of ATR when Listeria cells are habituated in lactic acid, and if the higher pHi can be maintained, the ATR would be stronger. The concentration of lactic acid per se has no significant effect on ATR, which it is proposed was due to the pHi homeostasis maintained within the cells. However, the difference in ATR among three strains was also significant, which cannot be explained by the stable pHi of all tested strains. Therefore, other underlying mechanisms to mediate ATR under different conditions need to be explored in further studies.

Investigation of muscle-specific beef color stability at different ultimate pHs.

OBJECTIVE: This study was aimed to investigate the muscle-specific beef color stability at normal and high ultimate pHs. METHODS: The impact of muscle (Longissimus lumborum [LL] vs psoas major [PM]) and pH (normal ultimate pH [Np] vs high pH dark cutting beef [Hp]) on color stability, indicated by basic color traits, metmyoglobin reducing activity (MRA) and oxygen consumption (OC), as well as the lipid oxidation, were determined over 7 days of display at 4°C. RESULTS: Hp-LL had the highest pH (6.92), followed by Hp-PM (6.01), Np-PM (5.76), and Np-LL (5.52). Hp-LL had increased (p<0.05) a*, chroma and % oxymyoglobin during display. Hp-LL also had the highest metmyoglobin (MMb) reducing activity and OC among all the samples, thus, the greatest color stability, although very dark throughout storage, with lowest values for lightness (L*) and yellowness (b*). Np-LL also exhibited relatively high color stability, as a result of its lower % MMb and OC and higher MRA than psoas muscle samples. The 0.2 unit difference of the pH between Hp and Np psoas muscle, resulted in the difference of the color intensity, not the color stability. Interestingly, high pH psoas muscle (Hp-PM) did not have better color stability than Np-PM, and in fact had lower color stability than even Np-LL. The similar level of OC and lipid oxidation cannot explain the difference in color stability between Hp-PM and Np-LL. CONCLUSION: The Hp does not always show better color stability compared with Np beef, which depends on the muscle type. The balance of MRA and OC is important to keep the color in great intensity and stability in the meantime.

Effect of different short-term high ambient temperature on chicken meat quality and ultra-structure.

OBJECTIVE: This study investigated the effect of different acute heat stress (HS) levels on chicken meat quality and ultra-structure. METHODS: Chickens were randomly divided into 7 groups to receive different HS treatments: i) 36°C for 1 h, ii) 36°C for 2 h, iii) 38°C for 1 h, iv) 38°C for 2 h, v) 40°C for 1 h, vi) 40°C for 2 h, and vii) un-stressed control group (25°C). Blood cortisol level, breasts initial temperature, color, pH, water holding capacity (WHC), protein solubility and ultra-structure were analyzed. RESULTS: HS temperatures had significant effects on breast meat temperature, lightness (L*), redness (a*), cooking loss and protein solubility (p<0.05). The HS at 36°C increased L*24 h value (p<0.01) and increased the cooking loss (p<0.05), but decreased a*24 h value (p<0.05). However, as the temperature increased to 38°C and 40°C, all the values of L*24 h, cooking loss and protein denaturation level decreased, and the differences disappeared compared to control group (p> 0.05). Only the ultimate pH24 h at 40°C decreased compared to the control group (p<0.01). The pH in 36°C group declined greater than other heat-stressed group in the first hour postmortem, which contributed breast muscle protein degeneration combining with high body temperature, and these variations reflected on poor meat quality parameters. The muscle fiber integrity level in group 40°C was much better than those in 36°C with the denatured position mainly focused on the interval of muscle fibers which probably contributes WHC and light reflection. CONCLUSION: HS at higher temperature (above 38°C) before slaughter did not always lead to more pale and lower WHC breast meat. Breast meat quality parameters had a regression trend as HS temperature raised from 36°C. The interval of muscle fibers at 24 h postmortem and greater pH decline rate with high body temperature in early postmortem period could be a reasonable explanation for the variation of meat quality parameters.

The Characterization of Biofilm Formation and Detection of Biofilm-Related Genes in Salmonella Isolated from Beef Processing Plants.

The biofilm formation behavior of Salmonella isolated from beef processing plants was investigated under varying temperatures (4°C, 10°C, 25°C, 37°C, and 42°C) and pH (4.5, 5.0, 5.5, 6.0, 7.0, and 8.0). The relationships between the presence of biofilm-related genes and the biofilm formation capacity were evaluated. A total of 77 Salmonella strains in 8 different serotypes were assessed: Salmonella Agona (n = 43), Salmonella Senftenberg (n = 13), Salmonella Meleagridis (n = 8), Salmonella Derby (n = 7), Salmonella Kottbus (n = 2), Salmonella Calabar (n = 2), Salmonella Kingston (n = 1), and Salmonella Typhimurium (n = 1). The results showed that all tested Salmonella strains produced biofilm at 25°C and 37°C after 3 d, and Salmonella Kingston and Salmonella Senftenberg had higher biofilm production than other strains under test conditions. Serotype, incubation temperature, pH, and their interactions had significant effects on biofilm formation for Salmonella. The strongest biofilm formation capacity of Salmonella (serovar Agona, Senftenberg, Kottbus, Calabar, Kingston, and Typhimurium) occurred at 25°C and at pH 7.0. Biofilm formation was significantly inhibited for all Salmonella strains incubated at 4°C. The detection rates of genes rpoS, fliC, wcaA, and invA were 100%, and the rates of genes csgB, csgD, csrA, sirA, adrA, gly, fimH, sdiA, ompR, sipB, sipC, luxS, and pfs exceeded 75% among all biofilm producer strains. The detection rate of igaA was significantly different between different biofilm producers. Based on the findings in this study, useful information on biofilm formation of Salmonella isolated from beef processing plants in China is provided, which could help clear the technological hurdle in delaying biofilm production to deal with risks from Salmonella biofilms in the beef industry.

Bio-protective potential of lactic acid bacteria: Effect of Lactobacillus sakei and Lactobacillus curvatus on changes of the microbial community in vacuum-packaged chilled beef.

OBJECTIVE: This study was to determine the bacterial diversity and monitor the community dynamic changes during storage of vacuum-packaged sliced raw beef as affected by Lactobacillus sakei and Lactobacillus curvatus. METHODS: L. sakei and L. curvatus were separately incubated in vacuumed-packaged raw beef as bio-protective cultures to inhibit the naturally contaminating microbial load. Dynamic changes of the microbial diversity of inoculated or non-inoculated (control) samples were monitored at 4°C for 0 to 38 days, using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE). RESULTS: The DGGE profiles of DNA directly extracted from non-inoculated control samples highlighted the order of appearance of spoilage bacteria during storage, showing that Enterbacteriaceae and Pseudomonas fragi emerged early, then Brochothrix thermosphacta shared the dominant position, and finally, Pseudomonas putida showed up became predominant. Compared with control, the inoculation of either L. sakei or L. curvatus significantly lowered the complexity of microbial diversity and inhibited the growth of spoilage bacteria (p<0.05). Interestingly, we also found that the dominant position of L. curvatus was replaced by indigenous L. sakei after 13 d for L. curvatus-inoculated samples. Plate counts on selective agars further showed that inoculation with L. sakei or L. curvatus obviously reduced the viable counts of Enterbacteraceae, Pseudomonas spp. and B. thermosphacta during later storage (p< 0.05), with L. sakei exerting greater inhibitory effect. Inoculation with both bio-protective cultures also significantly decreased the total volatile basic nitrogen values of stored samples (p<0.05). CONCLUSION: Taken together, the results proved the benefits of inoculation with lactic acid bacteria especially L. sakei as a potential way to inhibit growth of spoilage-related bacteria and improve the shelf life of vacuum-packaged raw beef.

Superior alignment but no difference in clinical outcome after minimally invasive computer-assisted unicompartmental knee arthroplasty (MICA-UKA).

PURPOSE: Variety of clinical trials have been published comparing the alignment of MICA-UKA with MI-UKA. However, to the best of our knowledge, no published study has showed whether radiological alignment by MICA-UKA has influence on the clinical results. The present study was conducted to compare the short-term results of MICA-UKA with MI-UKA. It was hypothesized that better alignment as well as clinical results was achieved by MICA-UKA as compared to MI-UKA. METHODS: The clinical and radiological results of 87 subjects who underwent primary UKA using either minimally invasive and computer-assisted technique (45 patients Group A) or minimally invasive technique (42 patients, Group B) were reported. Knee Society scores (KSSs), Knee Society functional scores (KSFSs), range of motion (ROM), and radiographic results were assessed and reported preoperatively and at 24-month follow-up. Total blood loss, operative time, and length of skin incision were compared. RESULTS: The accuracy of the implantations in relation to the coronal mechanical axis in Group A was significantly superior to that of Group B (P = 0.033). The femoral rotational profile revealed the prosthesis in Group A that was implanted with significantly less internal rotation than Group B (P = 0.025). Clinical results, with regard to ROMs and KSSs, as well as KSFSs were equally good in both the groups. The average blood loss in patients of Group A was significantly reduced as compared to patients of Group B. No significant difference was detected in terms of operative time or length of skin incision. CONCLUSIONS: It is suggested that MICA-UKA improves the implant alignment without increasing clinical results versus MI-UKA. We advocate that computer navigation should be considered when minimally invasive unicompartmental knee arthroplasty is performed. LEVEL OF EVIDENCE: Therapeutic study, Level II.

Effect of ultimate pH on postmortem myofibrillar protein degradation and meat quality characteristics of Chinese Yellow crossbreed cattle.

This paper describes the complex effects of postmortem ultimate pH (pHu) on Chinese Yellow crossbreed cattle quality during postmortem ageing and provides an explanation of how pHu affects beef tenderness. High pHu beef had the highest initial tenderness (P < 0.05) compared with other groups at 1 day postmortem. Intermediate and low pHu beef had similar initial WBSF at 1 day postmortem, but intermediate pHu beef had slower tenderization rate than low pHu beef (P < 0.05). Purge loss, cooking loss, L*, a*, and b* values decreased with increasing pHu during ageing (P < 0.05). Myofibril fragmentation index (MFI) was higher in high pHu beef than intermediate and low pHu beef throughout ageing (P < 0.05). Protein degradation studies found that desmin and troponin-T appeared degraded within 0.5 h postmortem for high and low pHu beef, compared to >2 days for intermediate pHu beef. Overall, Chinese Yellow crossbred cattle tenderness is related to pHu, which may be affected by proteolytic enzymatic activity. Therefore, pHu may be used to predict beef tenderness and other quality characteristics during postmortem ageing. To achieve consistent tenderness, different ageing times should be used, depending on pHu.

Minimal invasive and computer-assisted total knee replacement compared with the minimal invasive technique: a prospective, randomized trial with short-term outcomes.

INTRODUCTION: Up to now, no prospective, randomized comparisons between minimal invasive and computer-assisted total knee arthroplasty (MICA-TKA), and minimal invasive technique (MI-TKA) has been documented to evaluate not only clinical, but also radiologic results of the MICA-TKA. This prospective, randomized study was performed to compare the short-term results of MICA-TKA with minimal invasive technique MI-TKA for 6-month follow-up. PATIENTS AND METHODS: We reported the clinical and radiological results of 80 subjects who had cruciate-substituting, TKA-implanted primary total knee arthroplasties using either minimal invasive and computer-assisted technique (40 patients Group I) or minimal invasive technique (40 patients, Group II). Tourniquet time, length of skin incision, and total blood loss were compared. Knee society scores (KSSs), knee society functional scores (KSFSs), range of motion (ROM), and radiographic results were assessed and reported preoperatively and at 6-month follow-up. RESULTS: The accuracy of the implantations in relation to the coronal mechanical axis in Group I was superior to that of Group II (P < 0.05). The femoral rotational profile revealed the prosthesis in Group I that was implanted with significantly less internal rotation than in Group II. The average blood loss in patients of Group I was significantly reduced as compared to patients of Group II. No significant difference was detected in terms of tourniquet time or length of skin incision. Clinical results, with regard to ROMs and KSSs, as well as KSFSs were equally good in both the groups. CONCLUSIONS: Better alignment and similarity of good clinical results at short-term follow-up may provide subjects who receive MICA-TKA with long-term endurance of their implants. Further studies on longer-term outcomes and functional improvements are required to validate these possibilities.

Midterm outcomes of total cervical total disc replacement with Bryan prosthesis.

Short-term results have indicated that the Bryan cervical total disc replacement (TDR) favorably compares to anterior cervical decompression and fusion, while it is associated with fewer complications and higher levels of satisfaction. The aim of the present work was to assess the safety and efficacy of the device in the treatment for cervical degenerative disc disease, at 6-year follow-up. Fifty-eighty patients have performed their 6-year follow-up visit and have been analyzed clinically and radiologically. Clinical evaluation was based on neck disability index (NDI), visual analog scale (VAS), SF-36, and range of motion (ROM) at index levels. Each measurement was taken preoperatively and at 3 months, 6 months, 1 year, 3 years, and 6 years postoperatively. Complications and re-operations were also investigated. Occurrences of heterotopic ossifications (HO) and of adjacent level degeneration were detected by radiographs at 6-year follow-up. The mean NDI and VAS scores for arm and neck were significantly reduced for all postoperative periods compared with the average preoperative values. Motion was preserved at index levels (mean ROM = 8.6° ± 0.2° at 6 years), and 81.3 % of the segments were mobile at 6 years. HO was evident in 12/64 operated segments and not restricting the movement of the prosthesis in any case at 6-year follow-up. Six of sixty-four upper adjacent levels and 4/64 lower adjacent levels showed a slight degradation. There was 2 case of posterior migration of the prosthesis, which did not cause any clinical symptoms. No case showed evidence of subsidence, wear of the implant. At a 6-year follow-up, the cervical TDR using Bryan prosthesis displayed satisfactory clinical and radiographic outcomes without any significant complication. However, future efforts need to be directed toward the evaluation of a larger number of patients with longer follow-up.

Double-bundle versus single-bundle anterior cruciate ligament reconstructions: a prospective, randomized study with 2-year follow-up.

This prospective, randomized study was conducted to compare the short-term results of arthroscopic double-bundle with single-bundle anterior cruciate ligament (ACL) reconstruction. One hundred and eight patients with a symptomatic ACL rupture were randomized to either double-bundle (Group DB) or single-bundle (Group SB) ACL reconstruction. Follow-up was conducted at 6, 12, 18 and 24 months postoperatively. At the 24-month follow-up, 94 of the 108 patients (87%) were available for evaluation. The rotational stability, as evaluated by pivot shift test, was significantly superior in the Group DB to that in the Group SB. No significant difference with regard to ACL revisions, total flexion work, mean peak flexion torque and extension work between the groups was detected. There was no significant difference between the groups in terms of the Tegner activity score, the knee injury and osteoarthritis outcome score, the Lysholm functional score, anterior knee pain or mobility, subjective knee function. In addition, no significant difference in laxity on the Lachman test or the KT-1000 maximum manual force test was investigated. All the results were significantly more satisfactory at each follow-up period than preoperatively, in both groups. Both SB- and DB-ACL reconstruction resulted in satisfactory subjective outcome and objective stability. Both these techniques can therefore be considered as suitable alternatives for ACL reconstruction. Moreover, as it seems to be according to the pivot shift test, the risk for the development of degenerative changes of the knee joint in a long run could be smaller in the Group DB.