Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls

Background:

The most common first-line treatment of osteochondral lesions of the talus (OLTs) is microfracture. Although many patients do well with this procedure, a number fail and require reoperation. The mechanism of failure of microfracture is unknown, and to our knowledge there has been no research characterizing failed microfracture regarding histological and inflammatory makeup of these lesions that may contribute to failure.

Purpose:

To characterize the structural and biochemical makeup of failed microfracture lesions.

Study Design:

Case series; Level of evidence, 4.

Methods:

Specimens from 8 consecutive patients with symptomatic OLTs after microfracture who later underwent fresh osteochondral allograft transplantation were analyzed. For each patient, the failed microfracture specimen and a portion of the fresh allograft replacement tissue were collected. The allograft served as a control. Histology of the failed microfracture and the allograft replacement was scored using the Osteoarthritis Research Society International (OARSI) system. Surface roughness was also compared. In addition, tissue culture supernatants were analyzed for 16 secreted cytokines and matrix metalloproteinases (MMPs) responsible for inflammation, pain, cartilage damage, and chondrocyte death.

Results:

The OARSI grade, stage, and total score as well as surface smoothness were significantly worse in the failed microfracture sample, indicating better cartilage and bone morphology for the allografts compared with the failed microfracture lesions. Analyzed cytokines and MMPs were significantly elevated in the microfracture tissue culture supernatants when compared with fresh osteochondral tissue supernatants.

Conclusion:

These data demonstrate a significantly rougher cartilage surface, cartilage and subchondral bone histology that more closely resembles osteoarthritis, and elevated inflammatory cytokines and MMPs responsible for pain, inflammation, cartilage damage, and chondrocyte death when compared with fresh osteochondral allografts used as controls.

A novel electrochemical anodization cell for the synthesis of mesoporous silicon

A novel design of an electrochemical anodization cell dedicated to the synthesis of mesoporous, single-crystalline silicon is presented. First and foremost, the design principle follows user safety since electrochemical etching of silicon requires highly hazardous electrolytes based on hydrofluoric (HF) acid. The novel cell design allows for safe electrolyte handling prior, during, and post-etching. A peristaltic pump with HF-resistant fluoroelastomer tubing transfers electrolytes between dedicated reservoirs and the anodization cell. Due to the flexibility of the cell operation, different processing conditions can be realized providing a large parameter range for the attainable sample thickness, its porosity, and the mean pore size. Rapid etching on the order of several minutes to synthesize micrometer-thick porous silicon epilayers on bulk silicon is possible as well as long-time etching with continuous, controlled electrolyte flow for several days to prepare up to 1000 μm thick self-supporting porous silicon membranes. A highly adaptable, LabVIEW^™-based control software allows for user-defined etching profiles.

Lest Formalisms Impede Insight and Success: Evaluation in Health Informatics

Objectives: To illustrate the advantages of an open-ended formative evaluation approach using a project-specific selection of methods over the controlled trial approach in the evaluation of health information systems. To illustrate factors leading to success and others impeding it in a telehealth project.

Methods: The methods and results of an evaluation of the BC Telehealth Program are summarized.

Results: The evaluation gave a comprehensive picture of the project, including assessment of the effects of an array of telehealth applications, and their economic impact. Factors leading to success and others preventing it are identified from the level of overall program management to the project specifics. The results include unanticipated effects and explanations for their reasons of occurrence. Neither the comprehensiveness of information nor the timeliness was achieved in a related project using a controlled trial approach.

Conclusions: Not all types of health information system projects can be evaluated using the controlled trial approach. This approach may impede important insights. It is also usually much less efficient. Funding agencies and journal editors have to take this into account when selecting projects for funding and submissions for publication.

Lest formalisms impede insight and success: evaluation in health informatics--a case study

OBJECTIVES

To illustrate the advantages of an open-ended formative evaluation approach using a project-specific selection of methods over the controlled trial approach in the evaluation of health information systems. To illustrate factors leading to success and others impeding it in a telehealth project.

METHODS

The methods and results of an evaluation of the BC Telehealth Program are summarized.

RESULTS

The evaluation gave a comprehensive picture of the project, including assessment of the effects of an array of telehealth applications, and their economic impact. Factors leading to success and others preventing it are identified from the level of overall program management to the project specifics. The results include unanticipated effects and explanations for their reasons of occurrence. Neither the comprehensiveness of information nor the timeliness was achieved in a related project using a controlled trial approach.

CONCLUSIONS

Not all types of health information system projects can be evaluated using the controlled trial approach. This approach may impede important insights. It is also usually much less efficient. Funding agencies and journal editors have to take this into account when selecting projects for funding and submissions for publication.

304 TREATMENT OF BOAR SPERM WITH RESPIRATION INHIBITOR MENADIONE: EFFECTS ON MOTILITY, REACTIVE OXYGEN SPECIES (ROS), MITOCHONDRIAL TRANSMEMBRANE POTENTIAL (MMP), AND ATP CONTENT

Previously we found that live, fresh or thawed boar sperm show little tendency to accumulate ROS spontaneously, but live sperm accumulated ROS during a 30-min incubation with xanthine and xanthine oxidase and showed marked reduction in motility. High mitochondrial transmembrane potential (MMP) is required to drive the F0/F1 ATPase responsible for producing ATP in most cell types, and ATP is required for sperm motility. This experiment was conducted to investigate the effects of menadione (disrupter of electron transport at Complex I) on sperm motility, MMP, and ATP content. The incidence of cells with high MMP was determined by measuring the fluorescence of JC-1 aggregates bound to the inner mitochondrial membrane using flow cytometry. Computer-assisted motion analysis was conducted using the IVOS version 12 (Hamilton Thorne Research, Beverly, MA, USA), and ATP (pmoles/106 sperm) was determined using the luciferin-luciferase assay. Sperm from six boars were individually Percoll washed to eliminate seminal plasma and incubated at 40 � 106/mL with 0, 1, 10, or 30 �M menadione for 5, 30, 60, and 120 min at 38�C in a modified Tyrode's medium containing 0.1% polyvinyl alcohol with no bicarbonate or BSA. The formation of ROS was confirmed by measuring the red fluorescence developed by the oxidation of hydroethidine to ethidium using flow cytometry. Whereas the basal level of ethidium fluorescence in the absence of menadione was low (2% ethidium-positive cells at 5 min), 10 and 30 �M menadione increased (P < 0.05) the percentage of ethidium-positive cells to 47 and 87%, respectively, at 30 min. Sperm motility did not decrease significantly (79-83%) during the 120 min incubation with no menadione, but menadione caused a significant dose-related decrease (P < 0.05) over time, with 10 and 30 �M menadione decreasing motility to 60 and 40%, 51 and 7%, and 10 and 1% at 30, 60, and 120 min, respectively. JC-1 aggregate fluorescence intensity decreased (P < 0.05) by 45-60% in a dose-related fashion at 120 min compared to the same doses at 5 min. Sperm viability, as measured by number of propidium iodide negative cells, averaged 93.6% during the incubation and was not significantly affected by treatment. The effect of menadione on ATP content was much less than that on motility or JC-1 fluorescence intensity. Mean ATP content averaged 63 pmoles through 60 min at all menadione doses; at 120 min only 30 �M menadione decreased (P < 0.05) ATP to 43 pmoles, compared to all other treatments. Menadione caused an increase in ROS formation and a decline in MMP, which suggested uncoupling of the respiratory chain and oxidative phosphorylation. However, sperm ATP content was not highly correlated with motility. This suggests that ATP content was maintained by the activity of other intermediary metabolism pathways. The reduction in motility may have been due to a ROS induced lesion in ATP utilization or in the contractile apparatus of the cell.