Comparison of Two Fixation Methods in Treating Displaced Pediatric Tibial Eminence Fractures at Boston Childrens Hospital

Introduction: Tibial eminence fractures (TEF) occur most often in children, and disrupt the bony attachment of the anterior cruciate ligament (ACL) to the tibia. Displaced TEF are managed surgically with reduction and fixation of the displaced fragment. This study compares the two most common methods of surgical fixation, suture and screw fixation. Methods: A retrospective case-study review of 78 patients treated at Boston Childrens Hospital for tibial eminence fractures comparing surgical results following suture or screw fixation. Results: Seventy-eight tibial spine injuries were analyzed with an average age at surgery of 11. Thirty-six knees were treated with sutures versus 35 with screws. Sport related injuries were found to be the most common cause of TEF. Mild activity-related pain was reported in 23% of patients. It was noticed that concurrent meniscal pathology leads to statistically significantly higher rates of loss of flexion. The total complication rate of the cohort was found to be 33%. Conclusions: We concluded that no major outcome differences were seen with suture vs. screw fixation. Numerous observations can be made from this study regarding percentage of complications and residual symptoms. Future work will aim to follow patients prospectively for assessment of knee function

Recurrent mobile bearing dislocation after minimally invasive unicompartmental knee arthroplasty

Over the last three decades, unicompartmental knee arthroplasty (UKA) has varied in its popularity. More recently the minimally invasive technique with improved instrumentation has resulted in a strong resurgence of interest in unicompartmental arthroplasty. Either in long term or short ones, UKA has shown excellent results specially if the surgeon follows the very delicate criteria for case selection. Even though it is a very demanding technique, the indications for UKA have expanded and only time will allow us to evaluate these changes. There is a significant learning curve in performing UKA through the minimally invasive technique. We report a case of recurrent dislocation of a mobile bearing polyethylene insert which required conversion to a total knee arthroplasty.Transcurridas las últimas tres décadas, la artroplastia unicameral de rodilla (AUR) ha variado en popularidad y aceptación. Recientemente, la técnica miniinvasiva con el avance de la nueva instrumentación, han logrado una fuerte reaparición en el interés de la artroplastia unicompartimental. Ya en largas o breves series, la AUR presenta excelentes resultados en especial si, el cirujano sigue escrupulosamente los criterios de selección de casos. Las indicaciones para la AUR han sido ampliadas y, únicamente el tiempo nos facilitará el poder evaluar estas variaciones. Hay una notoria curva de aprendizaje en la ejecución de la AUR a través de la técnica miniinvasiva. Presentamos un caso de luxación recurrente de un platillo meniscal de polietileno móvil implantado, que precisó un recambio a una prótesis total de rodilla

Targeting the OB-Folds of Replication Protein A with Small Molecules

Replication protein A (RPA) is the main eukaryotic single-strand (ss) DNA-binding protein involved in DNA replication and repair. We have identified and developed two classes of small molecule inhibitors (SMIs) that show in vitro inhibition of the RPA-DNA interaction. We present further characterization of these SMIs with respect to their target binding, mechanism of action, and specificity. Both reversible and irreversible modes of inhibition are observed for the different classes of SMIs with one class found to specifically interact with DNA-binding domains A and B (DBD-A/B) of RPA. In comparison with other oligonucleotide/oligosaccharide binding-fold (OB-fold) containing ssDNA-binding proteins, one class of SMIs displayed specificity for the RPA protein. Together these data demonstrate that the specific targeting of a protein-DNA interaction can be exploited towards interrogating the cellular activity of RPA as well as increasing the efficacy of DNA-damaging chemotherapeutics used in cancer treatment

Novel PI3Kγ Mutation in a 44-Year-Old Man with Chronic Infections and Chronic Pelvic Pain

A 44-year-old man is presented here with 14 years of chronic purulent sinusitis, a chronic fungal rash of the scrotum, and chronic pelvic pain. Treatment with antifungal therapy resulted in symptom improvement, however he was unable to establish an effective long-term treatment regimen, resulting in debilitating symptoms. He had undergone extensive work-up without identifying a clear underlying etiology, although Candida species were cultured from the prostatic fluid. 100 genes involved in the cellular immune response were sequenced and a missense mutation was identified in the Ras-binding domain of PI3Kγ. PI3Kγ is a crucial signaling element in leukotaxis and other leukocyte functions. We hypothesize that his mutation led to his chronic infections and pelvic pain

Family History.

<p>Family History.</p

Imaging Test and Special Test/Procedure Results.

<p>Imaging Test and Special Test/Procedure Results.</p