Early outcomes of the oxford unicompartmental knee arthroplasty: 140 cases from a single institute in Taiwan

BACKGROUND

The clinical and radiologic outcomes of the Oxford Unicompartmental Knee Arthroplasty utilizing Microplasty® instrumentation have not been extensively investigated in Taiwanese patients. Despite the efficacy of this treatment for unicompartmental knee diseases, its specific impact on this population remains unknown.

METHODS

We retrospectively analyzed prospectively collected data of patients who underwent OUKA with MP between 2018 and 2021, including demographic information, component position, pre- and postoperative knee range of motion (ROM), numeric rating scale (NRS), and 2011 Knee Society Score-functional activity score (2011 KSS-FAS). We compared pre- and postoperative data and analyzed the correlation between clinical and radiographic outcomes.

RESULTS

Among 140 patients with an average age of 66.8 years, predominantly female, the majority exhibited components that fell within the radiographically acceptable tolerance ranges. The mean 2.5-year follow-up revealed significant improvements in knee ROM from 102.6° ± 12.9° to 127.3° ± 9.8° (p < 0.05), pain reduction from 7.7 ± 0.8 to 0.4 ± 0.7 (p < 0.001), and KSS-FAS from 30.7 ± 10.5 to 94.3 ± 5.2 (p < 0.001). Notably, a tibial component medial overhang within tolerance predicted shorter hospital stays, and a higher preoperative KSS correlated with lower postoperative NRS. No independent variables were identified as predictors of a higher postoperative KSS.

CONCLUSION

Our study on OUKA with MP in Taiwanese patients reveals promising early clinical and radiographic outcomes. Tibial component medial overhang <3 mm is associated with shorter hospital stays, and a higher preoperative KSS predicts lower NRS at 1 year postoperatively.

Exploring Physical Lumbar Microvascular Geometry Through Endoscopy and Illustrations: Implications for Clinical Interpretation

STUDY DESIGN

Retrospective Study.

OBJECTIVES

Minimally invasive endoscopic spinal surgery is gaining popularity, but our understanding of the lumbar spine's microvascular geometry relies heavily on cadaver studies and textbook illustrations. Additionally, inconsistent nomenclature of vessels in the literature hampers effective communication among surgeons. This study aims to improve the clarity and comprehensibility of the lumbar spinal microvascular geometry under endoscopic view.

METHODS

The study included 400 patients who underwent endoscopic spinal surgery for lumbar spinal canal stenosis and foraminal stenosis. The surgeries were performed by an experienced surgeon using either the interlaminar or transforaminal approach. Endoscopic video recordings were further analyzed to map the microvascular geometry and common bleeding foci. The observed results were cross-referenced with existing literature to reconstruct a comprehensive view of the vascular anatomy.

RESULTS

The transforaminal approach commonly encounters bleeding foci originating from the major branches of the segmental lumbar artery and the emissary veins within the foramen. The interlaminar approach primarily encounters bleeding foci from the muscle vessels in the dorsal lamina, which are believed to be located near the ends of the three main branches. In the intracanal region, epidural vessels form a rotary loop above the disc, which can contribute to most of the bleeding during discectomy.

CONCLUSIONS

This study provides a comprehensive understanding of the microvascular anatomy in the lumbar spine during endoscopic spinal surgery. Recognizing the geometry will help surgeons anticipate and control bleeding, reducing the risk of complications. The findings contribute to the improvement of surgical techniques and patient safety in endoscopic spinal surgery.

Enhancing endoscopic foraminal decompression in adult isthmic spondylolisthesis: the potential influence of lateral recess isthmic spur and our case series of an innovative craniocaudal interlaminar approach via unilateral biportal endoscopic spinal surgery

BACKGROUND

The NASS guideline cannot recommend any of the surgical treatment options toward adult isthmic spondylolisthesis (AIS) since 2014. After the introduction of endoscopic decompression, instead of treating the spondylolysis itself, treatment can specifically target the refractory radicular pain developed during the degeneration progress without devastating the peripheral soft tissue. However, we noticed that endoscopic transforaminal decompression seems to be less effective in AIS compared to other types of degenerative spondylolisthesis. Thus, we came up with a novel craniocaudal interlaminar approach, utilizing the proximal adjacent interlaminar space to perform bilateral decompression and observed the pathoanatomy of pars defect directly and tried to identify the cause of decompression failure.

METHODS

From January 2022 to June 2022, 13 patients with AIS underwent endoscopic decompression via the endoscopic craniocaudal interlaminar approach and were followed up for at least 6 months. Visual Analogue Scale, Oswestry Disability Index and MacNab scores were recorded to monitor patients' clinical recovery. All endoscopic procedures were recorded and reviewed to illustrate the pathoanatomy.

RESULTS

Four patients required minor revision via the same technique. One of them required it due to incomplete isthmic spur resection, two due to neglected disc protrusion, and the other due to root subpedicular kinking in higher grade anterolisthesis. All patients' clinical condition improved significantly subsequently. After reviewing the endoscopic video, we have observed that the hook-like, ragged spur originating from the isthmic defect extends beyond the region around the foramen. Instead, it extends proximally into the adjacent lateral recess, resulting in impingement along the fracture edge above the index foramen and, in some cases, even in the extraforaminal area.

CONCLUSIONS

The broad spanning isthmic spur extending to the proximal adjacent lateral recess might be the reason why the transforaminal approach yielded less satisfactory results due to the incomplete decompression result from approach related restriction. Our study demonstrated an optimistic outcome by applying decompression from the upper level. Therefore, we propose that the craniocaudal interlaminar approach might be a better route for decompression in adult isthmic spondylolisthesis.

A Novel Arthroscopic Transosseous Procedure for Rotator Cuff Repair: An Economical Freehand Method

Open transosseous repair was historically considered the gold-standard surgical solution for rotator cuff tears; however, with advancements in arthroscopic surgery, this procedure was largely replaced by anchor-based techniques. Yet, the ability of anchor-based techniques to achieve similar biomechanical fixation remains uncertain.In this article, we describe a reproducible, economical, arthroscopic anchorless transosseous rotator cuff repair technique that uses an Omega configuration. This technique involves two bone tunnels and four high-strength polyethylene sutures and is suitable for medium-to-large rotator cuff tears that would alternatively need multiple anchors. This procedure not only maximizes the tendon-footprint contact area without using any implanted device but also theoretically lowers the bone laceration rate and is cost effective. In the current Technical Note, the procedure is described in detail along with several tips and tricks.

CLASSIFICATIONS

Level I, shoulder; Level II, rotator cuff.

Treatment of Fabella syndrome with arthroscopic fabellectomy: a case series and literature review

Background

The fabella is a sesamoid bone in the posterolateral capsule of the human knee joint. In quadrupedal mammals, the fabella is believed to have a role similar to the patella in redirecting extension forces of the knee joint from one point to another. In bipeds, the fabella is not touching the back of the bent knee, and therefore the role in redirecting forces declines. Posterolateral knee pain can be associated with the irritation between the fabella and lateral femoral condyle, a phenomenon also known as fabella syndrome. In cases that are unresponsive to conservative management, surgical fabellectomy can be a successful treatment option. Among the surgical approaches, open resection is most commonly seen. There are also literature reporting arthroscopic-assisted open resection, but seldom mentioned the all-arthroscopic fabellectomy.

Case presentation

We present 3 patients with a long history (> 12 month) of posterolateral knee pain under suspicion of different pain origins. The diagnosis of fabella impingement was eventually made by ruling out of other causes. All the patients underwent all-arthroscopic fabellectomy for diagnosis and treatment. Investigations of the resected fabella suggested chronic impingement with apparent osteophyte formation and cartilage wearing of the articular side. All patients have been continually followed up at our outpatient department and reported to be pain free after the procedure.

Conclusions

In the patients presenting posterolateral pain, fabella syndrome cannot be ignored due to its relative higher presence in Asian population. In our experience, the all-arthroscopic fabellectomy offers a smaller wound size, less post-operative pain, fewer days of hospitalization and quicker time to rehabilitation for the patients with chronic posterolateral knee pain caused by fabella syndrome.

Visualizing Ferroelectric Uniformity of Hf1-xZrxO2 Films Using X-ray Mapping

Hf_1-xZr_xO₂ (HZO) is a complementary metal-oxide-semiconductor (CMOS)-compatible ferroelectric (FE) material with considerable potential for negative capacitance field-effect transistors, ferroelectric memory, and capacitors. At present, however, the deployment of HZO in CMOS integrated circuit (IC) technologies has stalled due to issues related to FE uniformity. Spatially mapping the FE distribution is one approach to facilitating the optimization of HZO thin films. This paper presents a novel technique based on synchrotron X-ray nanobeam absorption spectroscopy capable of mapping the three main phases of HZO (i.e., orthorhombic (O), tetragonal (T), and monoclinic (M)). The practical value of the proposed methodology when implemented in conjunction with kinetic-nucleation modeling is demonstrated by our development of a T → O annealing (TOA) process to optimize HZO films. This process produces an HZO film with the largest polarization values (P_s = 64.5 μC cm^-2; P_r = 35.17 μC cm^-2) so far, which can be attributed to M-phase suppression followed by low-temperature annealing for the induction of a T → O phase transition.

Effect of genistein and quercetin on proliferation, collagen synthesis, and type I procollagen mRNA levels of rat hepatic stellate cells

AIM

To study the effects of genistein (GE) and quercetin (QU) on proliferation, collagen synthesis, and procollagen messenger RNA (mRNA) expression of rat hepatic stellate cell line HSC-T6 cells.

METHODS

Cell proliferation was measured by crystal violet staining assay. Collagen synthesis was determined by [3H]proline incorporation assay. Type I mRNA level was determined by reverse transcription polymerase chain reaction (RT-PCR).

RESULTS

GE (25 - 70 micromol/L) and QU (6.25 - 50 micromol/L) concentration-dependently reduced serum-driven HSC-T6 cell proliferation and collagen synthesis associated with a suppression of type I procollagen mRNA level.

CONCLUSION

GE and QU inhibited hepatic stellate cell proliferation and collagen synthesis that might have a protective role against liver fibrosis.

[Antifibrotic effects of genistein and quercetin in vitro]

AIM

To study the antifibrotic effects of genistein (GE) and quercetin (QU) on rat hepatic stellate HSC-T6 cell proliferation stimulated with platelet-derived growth factor (PDGF), collagen synthesis and type I procollagen messenger RNA (mRNA) expression stimulated with transforming growth factor beta 1 (TGF beta 1).

METHODS

Cell proliferation was measured by crystal violet staining assay. Collagen synthesis was determined by 3H-proline incorporation assay. Type I procollagen mRNA level was determined by reverse transcription polymerase chain reaction (RT-PCR).

RESULTS

GE (25-70 mumol.L-1) and QU (6.25-50 mumol.L-1) concentration-dependently attenuated PDGF-drive HSC-T6 cell proliferative activity. TGF beta 1-stimulated collagen synthesis was also reduced. This was associated with a decrease of type I procollagen mRNA, indicating an effect at a pretranslational level.

CONCLUSION

GE and QU may have therapeutic potential against liver fibrosis by regulating PDGF and TGF beta 1 actions.

Beneficial effect of HCL-31D in murine models of endotoxaemia

We evaluated the effect of HCL-31D, a novel cAMP-specific phosphodiesterase inhibitor, on the induction of inducible nitric oxide synthase (iNOS) in lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma)-treated rat aortic smooth muscle cells (RASMC) and on survival in a murine model of severe endotoxaemia. Treatment of cultured RASMC with LPS and IFN-gamma resulted in an increase of nitrite, tumour necrosis factor (TNF-alpha) production and induction of iNOS mRNA. However, incubation with HCL-31D (1 approximately 50 microM) for 24 h caused significant attenuation of nitrite and TNF-alpha formation as well as iNOS mRNA induction in a dose-dependent manner but no effect on iNOS activity in RASMC. In addition, administration of HCL-31D (5 mg/kg, i.p.) resulted in that the increase of both plasma nitrate and TNF-alpha levels induced by LPS in vivo was significantly reduced in LPS-treated rats. Treatment of conscious mice with a high dose of LPS (60 mg/kg, i.p.) to ICR mice resulted in a 24-h survival rate of only 10%. However, administration of HCL-31D (5 mg/kg, i.p. at 0 h and 6 h after LPS) improved the 24-h survival to 50%, indicating that HCL-31D has a beneficial effect in murine model endotoxaemia. These effects may be mainly due to inhibition of TNF-alpha formation and of the induction of iNOS. We proposed that the elevation of cAMP levels by HCL-31D may be involved in the prevention of TNF-alpha formation and iNOS induction.

Quantitative assessments of physiological and biological parameters in psoriatic lesions and its correlations to the clinical severity of psoriasis

Twenty-nine psoriatics were examined using a model with clinical, physiological and pathological assessment parameters. The three parts in this assessment model include: (1) clinical assessment: psoriasis area and severity index (PASI); (2) assessment of skin physiology and microcirculation: water content of stratum corneum, water-holding capacity of stratum corneum, transepidermal water loss, intravital dynamic videocapillaroscopy-measuring the capillary diameters and blood cell velocity in proximal nailfold of ring finger, and fluorescence angiography-measuring transcapillary Na-fluorescein(NAF) diffusion; and (3) immunohistochemistry examination: markers of proliferation (Ki67Ag), differentiation (involucrin), and inflammation (neutrophil elastase, intercellular adhesion molecule-1(ICAM-1), endothelial leukocyte adhesion molecule-1(ELAM-1)). Our results showed both the transcapillary diffusion of NAF and the expression of cell markers-dermal neutrophil elastase, epidermal ELAM-1 and Ki67Ag--correlated significantly to PASI scores (P < 0.05, linear regression). According to our results, the increased capillary permeability and inflammation markers, and enhanced expression of Ki67Ag correlated very well with PASI score. These markers could serve as alternative methods for assessment of the clinical severity of psoriatic patients.

Gene expression profiling in the human hypothalamus-pituitary-adrenal axis and full-length cDNA cloning

The primary neuroendocrine interface, hypothalamus and pituitary, together with adrenals, constitute the major axis responsible for the maintenance of homeostasis and the response to the perturbations in the environment. The gene expression profiling in the human hypothalamus-pituitary-adrenal axis was catalogued by generating a large amount of expressed sequence tags (ESTs), followed by bioinformatics analysis (http://www.chgc.sh.cn/ database). Totally, 25,973 sequences of good quality were obtained from 31,130 clones (83.4%) from cDNA libraries of the hypothalamus, pituitary, and adrenal glands. After eliminating 5,347 sequences corresponding to repetitive elements and mtDNA, 20,626 ESTs could be assembled into 9, 175 clusters (3,979, 3,074, and 4,116 clusters in hypothalamus, pituitary, and adrenal glands, respectively) when overlapping ESTs were integrated. Of these clusters, 2,777 (30.3%) corresponded to known genes, 4,165 (44.8%) to dbESTs, and 2,233 (24.3%) to novel ESTs. The gene expression profiles reflected well the functional characteristics of the three levels in the hypothalamus-pituitary-adrenal axis, because most of the 20 genes with highest expression showed statistical difference in terms of tissue distribution, including a group of tissue-specific functional markers. Meanwhile, some findings were made with regard to the physiology of the axis, and 200 full-length cDNAs of novel genes were cloned and sequenced. All of these data may contribute to the understanding of the neuroendocrine regulation of human life.

Inhibitory effect of hexapeptide (RGRHGD) on platelet aggregation

The B chain of beta-bungarotoxin 1-6 sequence, RGRHGD, presents the highest local average hydrophilicity measured by Kyte and Doolittle modeling analysis. The RGRHGD holds parts of both RGD and KGD peptides, which have been reported as having high binding affinity to GPIIb-IIIa. The present study evaluates whether the synthesized hexapeptide, RGRHGD, has an antiplatelet effect and further elucidates the possible mechanisms of action. RGRHGD dose-dependently inhibited rabbit platelet aggregation and adenosine triphosphate release induced by arachidonic acid, collagen, platelet-activating factor, thrombin, or U46619 with the IC50 range of 82.7 to 510 microg/mL. The platelet thromboxane B2 formation induced by collagen or thrombin was also significantly decreased by RGRHGD, but there was no effect on arachidonic acid-induced thromboxane B2 formation. In addition, RGRHGD also inhibited the rise of intracellular calcium level stimulated by arachidonic acid, collagen, or thrombin in Fura 2-AM-loaded platelets. The adenosine 3',5'-cyclic monophosphate level of washed platelets was not affected by RGRHGD. In conclusion, these data indicate that the inhibitory effect of RGRHGD on platelet aggregation may be due to the attenuation of thromboxane A2 formation and intracellular calcium mobilization. In addition, this study may provide a useful method of finding potential therapeutic agents by using molecular modeling analysis.

Mechanism of inhibition of platelet aggregation by HCL-31D

The antiplatelet effect of the pyridazinone analogue, 4, 5-dihydro-6-[4-[2-hydroxy-3-(3,4 dimethoxybenzylamino)propoxy]naphth-1-yl]-3(2H)-pyridazinone (HCL-31D), was investigated in vitro with rabbit platelets. HCL-31D dose-dependently inhibited the platelet aggregation and ATP release induced by collagen (10 microg/ml), arachidonic acid (100 microM) or thrombin (0.1 U/ml) with an IC(50) of about 0.95-5.41 microM. HCL-31D (0.5-5 microM) increased the platelet cyclic AMP level in a dose-dependent manner. Furthermore, HCL-31D potentiated cyclic AMP formation caused by prostaglandin E(1) but not that caused by 3-isobutyl-1-methylxanthine (IBMX). HCL-31D also attenuated phosphoinositide breakdown and intracellular Ca(2+) elevation induced by collagen, arachidonic acid or thrombin. HCL-31D inhibited the formation of thromboxane B(2) induced by collagen or thrombin but not by arachidonic acid. In addition, HCL-31D did not affect platelet cylooxygenase and thromboxane synthase activity. These data indicate that HCL-31D is an inhibitor of phosphodiesterase and that its antiplatelet effect is mainly mediated by elevation of cyclic AMP levels.

Antimicrobial activity of synthetic all-D mastoparan M

Mastoparan M, a tetradecapeptide toxin (INKAIAALAKKLL-NH2) from hornet venom and its D-form mastoparan M were synthesized chemically. All D- and L-mastoparan M forms were found to adopt 28% alpha-helical structures in a 30% trifluroethanol solution as shown by the circular dichroism spectrum. All-D mastoparan M caused 3H-thymidine release from labeled bacterial cells after incubation for 1 h and complete cell lysis by 4 h. Both L- and D-mastoparan M showed strong activity against gram-positive and gram-negative bacteria. All-D mastoparan M showed 2-fold higher antibacterial activity than L-mastoparan M. The effects of all-D mastoparan M on the surface morphology of Staphylococcus aureus (ATCC29213) and Escherichia coli (ATCC25922) were studied by scanning-beam electron microscopy. Blast-like bleb extrusions on the surface of some S. aureus and swellings on the end of E. coli were seen after culture with all-D mastoparan M. These findings indicated the all-D mastoparan M could kill bacteria by disrupting cells.

Stimulation of TNF-alpha, IL-1beta and nitrite release from mouse cultured spleen cells and lavaged peritoneal cells by mastoparan M

Chemically synthesized mastoparan M, a tetradecapeptide toxin of venom (INLKAIAALAKKLL), was used in the experiments described. After addition of mastoparan M to cultures of mouse macrophages in vitro, tumour necrosis factor-alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were detected in the culture fluids by 12 h and their highest accumulation was observed by 24 h. Mastoparan M induced increases in both TNF-alpha secretion and mRNA level at the same time. Nitrite levels, which reflect nitric oxide synthesis, were also found to increase in the macrophage cultures at 24 h after mastoparan M addition. In vivo studies showed that mastoparan M induced the formation and accumulation of TNF-alpha, IL-1beta and nitrite in the peritoneal exudates of mice much faster at 90 min, 120 min and 180 min after mastoparan M injection, respectively. Similarly, significant increases in myeloperoxidase activity, a marker for neutrophil and macrophage content, were observed in the peritoneal lavage cells after intraperitoneal injection of mastoparan M. However, induction of nitrite by mastoparan M was completely inhibited by simultaneous addition of antimouse TNF-alpha antibody to the macrophage cultures. These results suggest that modulation of both neutrophil and macrophage influx by mastoparan M may be conveyed through TNF-alpha and IL-1beta secretion accompanied by nitrite formation.

The cytolytic action of all-D mastoparan M on tumor cell lines

All-D and all-L mastoparan M, a tetradecapeptide toxin (INLKAIAALAKKLL-NH2) from hornet venom, were chemically synthesized in this study. Under circular dichroism investigation, all-D and L-mastoparan M adopted a 30% alpha-helical structure in 30% trifluroethanol solution but only a 10% á-helical structure in phosphate solution. After being added to the cultures of tumor cell lines in vitro, D-mastoparan (12.5 micrograms/ml) directly inhibited the growth of the tumor cell lines Colo 225 (59%), KB (38%), Hep-2 (63%), H226Br (43%) and HeLa (54%) determined by the MTT assay. We also found that D-mastoparan M has a higher potency of antitumor cell activity in vitro than L-mastoparan M. When examined under the scanning-beam electron microscope, hollow, shrunk and collapsed structures of tumor cells could be seen, after being mixed with D-mastoparan M. The appearance of these morphological alterations indicated that mastoparan M inhibits the growth of tumor cells by direct lysis of target cells.

Inhibitory effect of quercetin on tumor necrosis factor and interleukin-1 beta pro-osteoclastic activities

AIM

To study the effects of quercetin on tumor necrosis factor (TNF) and interleukin-1 beta (IL-1 beta) pro-osteoclastic activities.

METHODS

[3H] TdR uptake by osteoblasts was used to measure cell proliferation, microspectrophotometer for cellular AIP activity using p-nitrophenyl phosphate as enzyme substrate, and radioimmunoassay for prostaglandin E2.

RESULTS

Quercetin 5-40 mumol.L-1 reduced the inhibition of cell proliferation and AIP activity induced by TNF or IL-1 beta in a concentration-dependent manner. PGE2 production stimulated by either cytokines was also reduced by quercetin at 20 and 40 mumol.L-1.

CONCLUSION

quercetin exerted a marked inhibitory effect on TNF and IL-1 activities, related to their pro-osteoclastic function.

[Inhibitory effects of protein kinase C inhibitors on tumor necrosis factor induced bovine pulmonary artery endothelial cell injuries]

The effects of protein kinase C(PKC) inhibitors 1-(5-isoquino-linylsulfonyl)-2-methylpeperazine (H-7) and quercetin on tumor necrosis factor (TNF) were studied in cultured bovine pulmonary artery endothelial cells (BPAEC) in vitro. Incubation of BPAEC with TNF caused a significant increase in percent lactate dehydrogenase (LDH) release, stimulation of EC-dependent neutrophils (PMN) adhesion to BPAEC and inhibition of BPAEC DNA synthesis and proliferation. All these were restored by both H-7 and quercetin. The IC50 of H-7 and quercetin was 9.7 and 10.8 mumol.L-1 for the inhibition of LDH% release; 19.5 and 16.7 mumol.L-1 for the inhibition of TNF-induced PMN-EC adhesion; 7.0 and 6.1 mumol.L-1 for TNF-induced inhibition of DNA synthesis and 8.7 and 11.36 mumol.L-1 for proliferation. These results suggest that PKC inhibitors H-7 and quercetin protect BPAEC from TNF induced injuries and PKC play an important role in EC activation by TNF.

The avian eggshell extracellular matrix as a model for biomineralization

The avian eggshell is a complex, extracellularly assembled structure which contains both mineralized and non-mineralized regions. The composition of the hen eggshell organic matrix was examined by immunohistochemistry with antibodies to different extracellular matrix molecules. Type I collagen is found in the shell membranes, but only after treatment of the tissue sections with pepsin. When incomplete eggshells are removed from the oviduct and immunostained, type I collagen can be detected in the shell membranes without pepsin treatment. The shell membranes, which are non-mineralized, also contain type X collagen, and this immunostaining does not require pepsin treatment. The occurrence of type X collagen in the shell membranes is surprising, since this collagen has not been found in any tissue other than hypertrophic cartilage. Immunostaining for various glycosaminoglycans shows the presence of keratan sulfate and dermatan sulfate. Several different antibodies to keratan sulfate stain different regions of the eggshell; one keratan sulfate epitope is prominent in the calcium reserve assemblies. Dermatan sulfate staining is very intense in the palisade region. Demineralized matrix from the palisade region was extracted with guanidine and fractionated by ion exchange chromatography. A approximately 200-kDa dermatan sulfate proteoglycan is found in these extracts, along with a number of protein components. This preparation was tested for its ability to affect calcium carbonate crystal formation in vitro. Pieces of demineralized shell membranes were used as a substrate for crystal formation and various amounts of the palisade matrix dermatan sulfate proteoglycan preparation were added to the solution from which the crystals were formed. This material causes a concentration-dependent change in crystal morphology to one in which the crystals are smaller and more rounded, which more closely approximates the crystals normally observed in eggshells. These results suggest that the dermatan sulfate proteoglycans may be important in modulating crystal morphology in the hen eggshell and correlate with mineralization-modulating biomolecules from other calcified tissue, which are generally anionic.

Protein kinase C inhibitor H-7 blocks effects of tumor necrosis factor on bone cells

AIM

To study the effects of tumor necrosis factor (TNF) on the neonatal mouse osteoblast-enriched calvarial cells and effects of protein kinase C (PK C) inhibitor, 1-(5-isoquinolinesulfonyl)-2 -methylpiperazine (H-7) on the TNF actions.

METHODS

[3H]TdR uptake by the osteoblasts was used to measure cell proliferation. Cellular alkaline phosphatase (AIP) and tartrate resistant acid phosphatase (trAcP) activities were determined spectrophotometrically.

RESULTS

TNF (1-100 kU . L-1) inhibited both proliferation and expression of AIP activity, but stimulated trAcP activity. These TNF-induced actions were blocked by simultaneous addition of H-7 (5-20 mumol . L-1).

CONCLUSION

TNF has potent effects on the osteoblasts, and the blockade of TNF actions by H-7 suggests that TNF exert its effects through PK C.

Crystallization studies on avian eggshell membranes: implications for the molecular factors controlling eggshell formation

The avian eggshell is a natural biopolymer and mineral composite. It is a very useful model for biomimetic mineralization, since it is among the fastest forming hard tissues known. Isolated eggshell membranes, which were demineralized in vitro, were used to investigate the in vitro modulation of CaCO3 crystal deposition by organic matrix materials. Crystallization on the demineralized eggshell membrane occurred almost exclusively at the peripheries of residual calcium reserve assemblies, which contain a high concentration of sulfur. Similar structures are observed for eggshell membranes after natural demineralization. The characteristic rhombohedral crystal morphologies of the calcite crystals grown in this in vitro system are much less regular when grown in the presence of organic matrix or partially purified dermatan sulfate proteoglycans obtained from the eggshell. The effect of these macromolecules on the morphology and size of CaCO3 crystals is concentration-dependent. These studies indicate the complexity of the molecular and ionic interactions involved in the initiation and formation of the eggshell, with the focus on the role of the organic matrix.

Mastoparan B, synthesis and its physical and biological properties

Mastoparan B, a tetradecapeptide toxin (LKLKSIVSWAKKVL) isolated from the hornet (Vespa basalis) venom, was synthesized chemically. The physical and biological properties of both the native and synthetic peptides were studied and proved to be identical. Mastoparan B was found to have a potent antibacterial activity to both Gram negative and Gram positive bacteria.

Seroma prevention after modified radical mastectomy

The most common mastectomy-associated complication is seroma formation. Seromas can be associated with other more serious complications such as skin flap necrosis, delayed wound healing, infection, and lymphedema. The flap tacking procedure that closes the axillary fossa dead space and tacks the mastectomy flaps to the chest wall has been suggested as one potential technique to reduce the incidence of postmastectomy seromas. This institution-wide study of modified radical mastectomies demonstrated a significant decrease (P < 0.0381) in the incidence of seroma when flap tacking was performed. Women who developed a seroma, compared to those who did not, averaged nearly twice as any office visits in the first 2 months after the operation. Distribution of office visits between the seroma patients and nonseroma patients was significant (P < 0.0001). When practiced by several surgeons, the flap tacking procedure 1) reduces postmastectomy seromas and 2) reduces the amount of postoperative patient office visits and care.

Maintenance error reduction strategies in nuclear power plants, using root cause analysis

This study proposes a conceptual model of maintenance tasks to facilitate the identification of root causes of human errors in carrying out such tasks in nuclear power plants. Based on this model, an external/internal classification scheme was developed to discover the root causes of human errors. As a consequence, certain policies pertaining to human error prevention or correction were proposed.

Serogrouping, plasmid and drug resistance of Pseudomonas aeruginosa in Taiwan

The Pseudomonas aeruginosa isolates in Taiwan were grouped with antisera against O antigens and tested with 13 different antimicrobial agents. Group E (28%) lead in serogrouping, followed by Group G (19%), Group F (16%), Group B and Group H (12%, respectively), and there were no significant differences in distribution of serogroups among the isolates from different areas in Taiwan. Amikacin (75%) and piperacillin (74%) were the most effective antibiotics, followed by tobramycin (63%), carbenicillin (62%), ticarcillin (57%) and gentamicin (56%). Group F strains were relatively more susceptible to most of the antibiotics tested than strains of other serogroups. All strains tested were multiple drug resistance. Thirty percent (67/224) of P. aeruginosa carried plasmids. The average number of resistant markers per strain was 8.7 for plasmid-carrying strains as compared to 7.6 for plasmid-free strains. The plasmid-carrying strains showed higher drug resistance than plasmid-free strains. Twenty-seven percent (13/48) of plasmid-carrying strains contained R plasmids which were detected by transformation (6/23) and conjugation (7/25). These R plasmids totally encoded at least seven different resistant markers. The R plasmid from P. aeruginosa 119 was not modified after transforming into Escherichia coli RR1. The R plasmids of P. aeruginosa transferred into E. coli RR1 or Serratia marcescens 73 caused some changes in the outer membrane of transformants or transconjugants. Some R plasmid-carrying strains and their transformants or transconjugants exhibited the ability to produce acetyltransferase.